BIOL121 Medical Science Eshma Case Study

Scenario: Eshma

Eshma is a 42-year-old marathon runner, who has presented to her GP clinic after completing a training run. She runs four to five times per week and does yoga or Pilates on the other days. Eshma has experienced light-headedness and significant muscle pain after her last three runs. Whilst talking to the clinic nurse, Eshma admits to feeling lethargic and like her “heart is racing”. She has also been a little unsteady on her feet and stumbled climbing the stairs in her home the previous evening. She reveals that, although she is still eating well and drinking adequate fluids, her caloric intake has been less than usual. She has lost 2 kg in the last month, and her last period was 5 months ago. Blood and urine tests ruled out pregnancy as a cause of amenorrhea.

Eshma applied Voltaren Emulgel, a topical non-steroidal anti-inflammatory drug (NSAID), to her quadriceps and calves immediately after this morning’s run, hoping to relieve some of her muscle soreness.

A medical history was taken, and urinalysis conducted, identifying the following:Height,Weight,Appearance,Temperature,Blood Group,HR,BP,Respiratory rate

All topics and their key points listed below must be discussed in your essay

Topic 1: Reproduction (10 marks total)

Endometrial tissue contains glandular structures relevant to Eshma’s reproductive function. Explain the role of this glandular tissue in reproductive function, including any likely changes from normal in the secretion and resultant effects for Eshma. (4 marks)

Considering Eshma and her current circumstances, describe the role of oestrogen and explain whether you expect her oestrogen levels to be different to normal. Your discussion should include the homeostatic regulation of female reproductive physiology and the relevant glands and hormones. (6 marks)

Topic 2: Respiratory system (5 marks total)

Describe the changes in volume and pressure that will be occurring in Eshma’s chest cavity during exhalation on a long run. Explain why these changes are occurring, and the effect upon airflow. (5 marks)

Topic 3: Digestion/metabolism (8 marks total)

Eshma supplements her diet with a daily protein shake after exercise. Today though, Eshma is experiencing some discomfort with indigestion, so takes a dose of Gaviscon® Dual Action soon after drinking her shake. Discuss how taking Gaviscon® Dual Action could affect digestion of the protein in her shake. (4.5 marks)

State the hormone that is MOST active in maintaining Eshma’s blood glucose levels during a marathon. Explain your answer. (3.5 marks)

Topic 4: Pharmacology (7 marks total)

In the past Eshma has used Voltaren Emulgel (containing an NSAID) to ease her aching muscles after exercise. However, a friend has mentioned that Voltaren is also available in tablet form and may be better for the “task”.

Compare and contrast the two different formulations of Voltaren available to Esham. In your answer you will need to examine the following: (7 marks)

• Where the drug is likely to be absorbed in each form
• Likely bioavailability of each form and susceptibility to hepatic first pass effect
• Why would the oral form be better?