Biology of Disease Case Studies (NTU)

BIOL40013 - Biology of Disease Student Information for Clinical Diagnosis practical session Introduction: In this practical session you are expected to carryout simple laboratory tests such as:Microplate reader – Plasma glucose levels  Clinistix test – Urinary glucose  Ketone bodies – Rothra’s test  Protein detection test  A separate protocol sheet explaining how to carry out these laboratory investigations will be supplied to the students. The results from the lab should be used by each student in conjunction with the clinical data, produce a comparative glucose tolerance (GTT) curve and diagnose the disease in each case study. The normal GTT curve will be supplied. Student should plot GTT graph for each case study and complete the diagnosis with the normal curve. The expectation: Students are expected to work in pairs. The aim of the lab is to reinforce what you have learnt about diagnosing diabetes in your lectures. On completion of this lab, you need to justify your diagnosis by answering the questions in the coursework guidelines. Students are expected to complete a structured diagnosis report and submit the report for coursework assessment. In next week seminar, TWO example case studies (A & B) will be discussed. The remaining SIX case studies (C to H) (will be provided during the seminar) should be diagnosed and submit the report. For COURSEWORK ASSESSMENT: Case studies for Diagnosis: Case study C: Pauline is an 82-year-old Hispanic woman who presented to her primary care physician with a 10-year history of episodic confusion. The episodes occurred about twice a year, typically in the morning, just after waking. They lasted minutes and were relieved when she ate her breakfast or had juice. She also complains of frequent urge to urinate and increased appetite. She also had leg ulcers. Her vital signs were significant only for mild hypertension. Her physical and neurological exams were unremarkable. She was asked to visit the following week to carry out a glucose tolerance test (GTT). The blood as well as his urine samples taken at different time points are available for you to carry out the diagnostic tests. Case study D: A 38-year old man with an 11-year history of type 1 diabetes, which was generally well controlled. For the past nine years he had followed a basal bolus insulin regimen and monitored his blood glucose regularly. He had no evidence of diabetic complications. On attending a party, he administered his evening insulin injection two hours later than usual. He drank four glasses of wine with a meal and joined in the dancing that followed. Approximately three hours after retiring to bed, he experienced dizziness with a subsequent convulsion. His blood as well as his urine samples taken at different time points after GTT are available for you to carry out the diagnostic tests. Case study E: A 22-year old young man collapsed from dehydration during a military exercise in the dessert. On admission to nearest army hospital, the patient complained of tiredness and nighttime sweating. He also stated he has the urge to urinate all the time. His blood pressure was found to be 98/72 mm Hg with the slow heart rate. There are no abnormal findings in his ECG. He was asked to visit the following week to carry out a glucose tolerance test (GTT). The blood as well as his urine samples taken at different time points are available for you to carry out the diagnostic tests. Case study F: A 33-year-old African woman presented to the clinic with complaints of coughing, a "tightening and lump" sensation in the throat for approximately four to five months, and generalized weakness. The patient also complained of a 10-lb weight loss over a six-month period. On physical examination, the patient's vital signs were temperature, 99.4°F, pulse, 92 beats per minute, blood pressure, 114/62 mmHg. Examination of the neck revealed a diffusely enlarged thyroid gland. The cardiac examination was revealed a systolic murmur. She was asked to visit the following week to carry out a glucose tolerance test (GTT). The blood as well as his urine samples taken at different time points are available for you to carry out the diagnostic tests. Case study G: Martin was admitted to hospital with hypertension. In examination he was found to be obese, with dyslipidemia. He also complained of dizziness and lethargy. He was unable to concentrate on anything. A full body CT scan was carried out which revealed a 5 mm lump in the pancreas. He was asked to visit the following week to carry out a glucose tolerance test (GTT). The blood as well as his urine samples taken at different time points are available for you to carry out the diagnostic tests. Case study H: A 33-year-old woman with severe and persisting fatigue over 3 years. Six months before the visit, her fatigue-associated symptoms became extremely serious, which led her to take time off work as a government employee. She complained of complex symptoms, including indigestion, anorexia, frequent sighing, easy exhaustion and loss of libido. She had no specific family or past history of diseases including hypertension, or diabetes mellitus. she was asked to visit the following week to carry out a glucose tolerance test (GTT). The blood as well as his urine samples taken at different time points are available for you to carry out the diagnostic tests.