The Case of the Sweaty Salesman Case Study Assignment

The Case of the Sweaty Salesman Case Study Assignment

Michael is a 30 year old salesman, who spends approximately 4 days each week traveling to visit with customers in his region. During his routine physical, he casually mentions to his physician that he seems to be sweating more profusely than normal and mentions that most rooms that once felt comfortable are now too "hot". He thought that it was simply due to the change in seasons and companies being slow to turn down the thermostats from the winter temperatures, however, this problem seems to persist even when he is at home. A room that his wife and children find to be comfortable causes him to sweat profusely. The Case of the Sweaty Salesman Case Study Assignment. Michael also reports that he seems to be loosing weight even though his appetite has increased. He also complains that he has a shortened attention span and that he always wants to be moving around. Despite the fact that he feels fatigued, Michael claims to have difficulty sleeping and seems to have more frequent bowel movements, occasionally accompanied by diarrhea.

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The physician checks Michael's medical history and finds that, indeed, he has lost 15 pounds since his last physical. The Case of the Sweaty Salesman Case Study Assignment. Wanting to rule out the possibility of infection with the human immunodeficiency virus (HIV), the physician asks Michael questions about his sexual history and practices and finds that he is not at risk for HIV infection. Also, in checking his chart, the physician finds that Michael has a negative history for chronic illnesses, does not smoke, and has a low risk for cardiovascular disease. He does, however, have a positive family history for autoimmune diseases. His father suffers from idiopathic thrombocytopenia, his mother has been diagnosed with rheumatoid arthritis and his oldest sister was recently diagnosed with systemic lupus erythematosus. The Case of the Sweaty Salesman Case Study Assignment

Results of Michael's physical examination were within normal ranges with the exception of the following: he demonstrated tachycardia, loud heart sounds, and apparent cardiac arrhythmias accompanied by slight hypertension. These arrhythmias were confirmed by electrocardiogram to be supraventricular in origin. Michael's eyeballs appeared large and protruding and his hair was fine and soft. He was also beginning to demonstrate some degree of alopecia. Michael was also observed to have palmar erythema. The Case of the Sweaty Salesman Case Study Assignment. Palpation of the neck revealed the presence of goiter. Results of blood tests indicated elevated concentrations of thyroid hormones (thyroxin and triiodothyronine), hypercalcemia, and decreased circulating concentrations of lipids. Based on the physical characteristics and the results of the blood tests, Michael's physician suspected that Michael was suffering from some form of hyperthyroidism and sent him to an endocrinologist to confirm the initial diagnosis. The Case of the Sweaty Salesman Case Study Assignment

Following the initial consultation and examination, the endocrinologist ordered tests to determine whether Michael has a hyperthyroid. The test results indicated an elevation in the concentration of thyroid hormones in the blood and the presence of thyroid-stimulating antibodies. These antibodies specifically stimulate the thyroid gland by binding with the thyroid stimulating hormone receptor located on the plasma membrane of the follicular cells of the thyroid gland. Based on these results, the endocrinologist concluded that Michael has Grave's disease, a form of hyperthyroidism believed to be autoimmune in nature. The Case of the Sweaty Salesman Case Study Assignment. Michael was presented with a number of possible treatment options. These included treatment with chemicals (propylthiouracil and methimazole) that decrease the production of thyroid hormones by the thyroid gland, radioisotopic destruction of the thyroid gland by the use of 131I, and surgical removal of the thyroid gland. After considering all the options, especially the possible effects of radiation on gamete development, Michael chose surgery. Following successful surgery, Michael was prescribed synthetic thyroid hormone to ensure that his body was receiving adequate thyroid hormone and was told to return within 2 months for a follow-up evaluation of circulating thyroid hormone concentrations. He was also cautioned to carefully monitor his calcium intake. The Case of the Sweaty Salesman Case Study Assignment

Using the the terms covered this week answer the following questions about this case:

Why would an imbalance in thyroid hormones have such a widespread effect on the body? Why was a goiter observed in Michael’s neck? Given that Michael and his wife may want to have more children, why was radioisotope, for the destruction of the thyroid gland, ruled out? The Case of the Sweaty Salesman Case Study Assignment

Here are the discussion board requirements.

  • The initial discussion post must be at least 250 words of content, referencing the reading of the week, and include a scholarly source. The Case of the Sweaty Salesman Case Study Assignment

Endocrine System

Chapter 13

Related Combining Forms

Structure Related Combining Forms
Adrenal glands adren/o
Gonads gonad/o
Male: testicles testic/o
Female: ovaries ovari/o
Pancreatic islets pancreat/o
Parathyroid glands parathyroid/o
Pineal gland pineal/o
Pituitary gland pituit/o, pituitar/o
Thymus thym/o
Thyroid gland thyr/o, thyroid/o

Functions of Endocrine System

Production of hormones that work together to maintain homeostasis

Hormones

Chemical messengers secreted by endocrine glands directly into the blood stream reaching target cells and organs

Regulate activities of specific cells and organs. The Case of the Sweaty Salesman Case Study Assignment

Structures of Endocrine System

Endocrine glands

Produce hormones

Are ductless

(endo-: within; -crine: to secrete)

13 major glands

One pituitary gland; one pineal gland; one thyroid gland; four parathyroid glands; one thymus; one pancreas; two adrenal glands; two gonads

Structures of Endocrine System

Pituitary Gland

Located below hypothalamus in the brain

Two divisions

Anterior lobe

Posterior lobe

Secretes hormones controlling the activity of other endocrine glands

Responds to stimuli from neurohormones to maintain appropriate levels of hormones

Pituitary Gland

The Case of the Sweaty Salesman Case Study Assignment

Secretions of Pituitary Gland: Anterior Lobe

Adrenocorticotropic Hormone (ACTH)

Stimulates growth/secretions of adrenal cortex

(adren/o: adrenal; cortic/o: cortex; trop: change)

Follicle-Stimulating Hormone (FSH)

Stimulates secretion of estrogen and growth of ova in the ovaries of females

Stimulates production of sperm in the testicles of males

Secretions of Pituitary Gland: Anterior Lobe

Growth Hormone (GH)

Regulates growth of bone, muscle, and other body tissues

Also known as somatotropic hormone

(somat/o: body)

Lactogenic Hormone (LTH)

Stimulates and maintains secretion of breast milk in mother after childbirth

(lact/o: milk; gen-: producing) The Case of the Sweaty Salesman Case Study Assignment

Secretions of Pituitary Gland: Anterior Lobe

Luteinizing Hormone (LH)

Stimulates ovulation in females

Stimulates secretion of testosterone in males

Melanocyte-Stimulating Hormone (MSH)

Increases production of melanin, causing darkening of skin

Thyroid-Stimulating Hormone (TSH)

Stimulates secretion of hormones by the thyroid

Secretions of Pituitary Gland: Posterior Lobe

Antidiuretic Hormone (ADH)

Secreted by hypothalamus and stored in pituitary gland

Helps control blood pressure by reducing amount of water excreted through kidneys

Secretions of Pituitary Gland: Posterior Lobe

Oxytocin (OXT)

Stimulates uterine contractions during childbirth

Controls postnatal hemorrhage

Stimulates flow of milk from mammary glands

(oxy-: swift; -tocin: labor) The Case of the Sweaty Salesman Case Study Assignment

Pineal Gland

Located in the central portion of the brain

Functions and Secretions

Secretions influence sleep-wakefulness cycle also called circadian cycle

Melatonin is the hormone responsible for this cycle

Pineal Gland

Thyroid Gland

Lies on either side of the larynx, just below the thyroid cartilage

Functions

Regulates body metabolism

Influences growth and functioning of nervous system

Thyroid Gland

Secretions

Two primary hormones regulate metabolic rate and affect growth and rate of function of many body systems

Thyroxine (T4)

Triiodothyronine (T3)

(rate of secretion controlled by TSH produced by anterior lobe of pituitary gland)

Thyroid Gland

Secretions

Calcitonin

Works with parathyroid hormone, decreases calcium levels in the blood and tissues by moving calcium into storage in bones and teeth

Parathyroid Glands

Four glands embedded in the posterior surface of thyroid gland

Functions

Regulate calcium levels

Secretions

Parathyroid Hormone (PTH)

Works with calcitonin to regulate calcium levels in the blood and tissues

Parathyroid Glands

The Case of the Sweaty Salesman Case Study Assignment

Thymus

Located near midline in anterior portion of thoracic cavity; posterior to sternum; superior to heart

Functions

Helps develop immune system before birth and in childhood

Reduced function after puberty as it turns into fatty tissue

Thymus

Secretions

Thymosin

Stimulates maturation of lymphocytes into T cells

Pancreas (Pancreatic Islets)

Pancreas functions as a part of digestive as well as endocrine system

Pancreatic islets have the endocrine function

Pancreas (Pancreatic Islets)

Functions of the pancreatic islets

Controls blood glucose levels and glucose metabolism throughout the body

Secretions of the pancreatic islets

Glucose

Basic form of energy used by the body

Pancreas (Pancreatic Islets) The Case of the Sweaty Salesman Case Study Assignment

Secretions of the pancreatic islets

Glucagon

Hormone secreted by alpha cells in response to the low levels of blood glucose

Increases glucose level by stimulating liver to convert glycogen into glucose to be released into bloodstream

Pancreas (Pancreatic Islets)

Secretions of the pancreatic islets

Insulin

Hormone secreted by beta cells in response to the high levels of blood glucose

Allows glucose to enter the cells to be used as energy

Stimulates liver to convert glucose into glycogen for storage when additional glucose is not needed

Adrenal Glands. The Case of the Sweaty Salesman Case Study Assignment

Located on the top of each kidney

Adrenal cortex = outer portion

Adrenal medulla = middle portion

Adrenal Glands

The Case of the Sweaty Salesman Case Study Assignment

Functions of Adrenal Glands

Control electrolyte levels within the body

Electrolytes: calcium, chloride, magnesium, phosphorus, sodium, and potassium normally found in blood and other body fluids

Help regulate metabolism and interaction with sympathetic nervous system in response to stress

Secretions of Adrenal Cortex

Androgens

Sex hormones secreted by gonads, adrenal cortex, and fat cells

Corticosteroids

Steroid hormones

Aldosterone regulates sodium and water levels by increasing sodium reabsorption and potassium excretion by the kidneys

Cortisol has anti-inflammatory action

Secretions of Adrenal Medulla

Epinephrine

Stimulates sympathetic nervous system in response to the physical injury or mental stress

Nonepinephrine

Released as a hormone by adrenal medulla and as a neurohormone by sympathetic nervous system

Gonads

Gamete-producing glands

Ovaries in females

Testicles in males

Gamete = reproductive cell

Functions of Gonads

Secrete hormones responsible for development and maintenance of secondary sex characteristics that develop during puberty

Puberty. The Case of the Sweaty Salesman Case Study Assignment

Physical changes by which child's body becomes adult body capable of reproducing

Secretions of Gonads

Estrogen

Secreted by ovaries

The Case of the Sweaty Salesman Case Study Assignment

Important in development and maintenance of female secondary sex characteristics and in regulation of menstrual cycle

Progesterone

Released during second half of the menstrual cycle

Secretions of Gonads

Gonadotropin

Any hormone that stimulates the gonads

(gonad/o: gonad)

Androgens

Primarily testosterone, secreted by gonads, adrenal cortex, and fat cells

Promote development and maintenance of male sex characteristics

Secretions of Gonads

Testosterone

Steroid hormone secreted by testicles and adrenal cortex

Stimulates development of male secondary sex characteristics

Estrogen and testosterone are present in males and females both but in different amounts depending on the gender

Specialized Types of Hormones

Have different chemical structure or are not secreted by endocrine glands directly into the bloodstream

Steroids

Secreted by endocrine glands or artificially produced as medications to relieve swelling and inflammation

Specialized Types of Hormones

Anabolic steroids

Man-made substances chemically related to male sex hormones

Used to treat hormone imbalance in men and to help the body replace muscle mass caused by disease

May be used illegally by athletes to build muscle mass

Hormones Secreted by Fat Cells

Leptin. The Case of the Sweaty Salesman Case Study Assignment

Protein hormone involved in the regulation of appetite

Acts on hypothalamus to suppress appetite and burn fat stored in adipose tissue

Ghrelin

Produced in GI tract

Referred to as "hunger" hormone

Neurohormones

Produced and released by neurons in the brain and delivered to various organs/tissues through the bloodstream

Medical Specialties Related to Endocrine System

Endocrinologist

Specializes in diagnosing/treating diseases and malfunctions of endocrine glands

Certified diabetes educator

Qualified to teach people with diabetes to manage their disease

Pathology of Endocrine System

Pituitary gland

Acromegaly

The Case of the Sweaty Salesman Case Study Assignment

Abnormal enlargement of hands/feet due to excessive secretion of growth hormone after puberty

(acr/o: extremities)

Gigantism

Abnormal growth of entire body caused by excessive secretion of growth hormone before puberty

Pathology of Endocrine System

Pituitary gland

Hyperpituitarism

Excess secretion of growth hormone causing acromegaly and gigantism

Short stature

May be due to deficient secretion of growth hormone

Pituitary adenoma

Slow-growing benign tumor of pituitary gland

Pathology of Endocrine System

Pituitary gland

Galactorrhea

Excess of prolactin causing breasts to produce milk spontaneously

Prolactinoma

Benign tumor of pituitary gland

(pro: on behalf of; lactin: milk)

Antidiuretic Hormone Conditions

Diabetes insipidus

Caused by insufficient production of ADH or inability of kidneys to respond appropriately to this hormone

Too much fluid is excreted by the kidneys

The Case of the Sweaty Salesman Case Study Assignment

Syndrome of inappropriate antidiuretic hormone

Overproduction of ADH leading to water retention

Pathology of Pineal Gland

Pinealoma

Tumor causing disruption of the production of melatonin

May cause insomnia by disrupting circadian cycle

Thyroid Gland

Thyroid carcinoma

Most common cancer of endocrine system

Affects more women than men

Insufficient Thyroid Secretion

Hashimoto's disease

Autoimmune disease in which body's antibodies attack and destroy cells of the thyroid gland

Hypothyroidism

Deficiency of thyroid secretion

Insufficient Thyroid Secretion

Cretinism

Congenital form of hypothyroidism

Lack of treatment leads to arrested physical and mental development

Myxedema

Extreme deficiency of thyroid secretion in the adult

Excessive Thyroid Secretion

Thyroid storm

Life-threatening condition due to exaggerated hyperthyroidism

Hyperthyroidism

Overproduction of thyroid hormones

Causes imbalance of metabolism

Graves' Disease

Immune system attacks thyroid gland stimulating the production of excessive amounts of thyroid hormone

Goiter

Abnormal benign enlargement of thyroid gland

Swelling in front of the neck

Exophthalmos

Abnormal protrusion of eyeball out of the orbit

Parathyroid Glands

Hyperparathyroidism

Overproduction of parathyroid hormone leading to hypercalcemia

Hypercalcemia

Abnormally high concentration of calcium circulating in the blood, instead of being stored in bones and teeth

Parathyroid Glands

Hypoparathyroidism

The Case of the Sweaty Salesman Case Study Assignment

Insufficient secretion of parathyroid hormone causing hypocalcemia

Hypocalcemia

Abnormally low levels of calcium in blood

Thymus

Thymitis

Inflammation of thymus gland

(thym: thymus)

Pancreas

Insulinoma

Benign tumor of pancreas causing hypoglycemia by secreting additional insulin

Pancreatitis

Inflammation of pancreas

Often due to long-term alcohol abuse

Abnormal Blood Glucose Levels

Hyperglycemia

Abnormally high concentration of glucose in blood

(glyc: sugar)

Symptoms include polydipsia, polyphagia, and polyuria

Polydipsia

Excessive thirst

(-dipsia: thirst)

Abnormal Blood Glucose Levels

Polyphagia

Excessive hunger

(-phagia: eating)

Polyuria

Excessive urination

(-uria: urination)

Abnormal Blood Glucose Levels

Hyperinsulinism

Excessive secretion of insulin in the bloodstream

Hypoglycemia

Abnormally low concentration of glucose in the blood

Diabetes Mellitus

Most common endocrine system disease

Metabolic disorder characterized by hyperglycemia due to defects in the production of insulin or inability to use it properly

Classified as Type 1, Type 2, or Type 1.5

The Case of the Sweaty Salesman Case Study Assignment

Type 1 Diabetes

Autoimmune insulin deficiency disorder

Caused by destruction of pancreatic islet beta cells

Treatment: diet, exercise, and insulin replacement therapy administered by injection or insulin pump

Type 2 Diabetes

Insulin resistance disorder

Inefficient use of insulin by the body

Patient may be asymptomatic for years

Treatment: diet, exercise, and oral medications

Latent Autoimmune Diabetes in Adults

Known as Type 1.5 diabetes

Development of Type 1 diabetes in adults

Shares characteristics of Type 2, but with autoimmune antibodies

Often occurs in adults of normal weight, and family history of Type 1 diabetes

Treatment: diet, exercise, oral medications, and insulin

Gestational Diabetes Mellitus

Occurs during some pregnancies

Usually disappears after delivery

Diabetic Emergencies

Diabetic coma

Due to hyperglycemia

Treatment: prompt administration of insulin

Insulin shock

Due to hypoglycemia

Treatment: administration of oral glucose that can be rapidly absorbed into bloodstream

Diabetic Complications

Diabetic retinopathy

Damage to blood vessels in the retina

Blood leaks into posterior segment of eyeball resulting in loss of vision

Heart disease

Walls of blood vessels become rigid

Diabetic Complications

Ketosis

High levels of ketones indicate insufficient production of insulin to convert glucose into energy

Kidney disease

Due to damage to the blood vessels and reduction of blood flow to the kidneys

Diabetic Complications

The Case of the Sweaty Salesman Case Study Assignment

Peripheral neuropathy

Damage to the nerves affecting hands and feet

Causes slow wound healing

Adrenal Glands

Addison's disease

Adrenal glands do not produce enough cortisol or aldosterone

Adrenalitis

Inflammation of adrenal glands

Aldosteronism

Electrolyte imbalance due to excessive secretion of aldosterone

Adrenal Glands

Conn's syndrome

Due to excessive production of aldosterone

Primary form of aldosteronism

Pheochromocytoma

Benign tumor of the adrenal gland causing high amount of secretions of epinephrine and norepinephrine

(phe/o: dusky; chrom/o: color)

Cushing's Syndrome

Prolonged exposure to the high levels of cortisol

May be due to body's overproduction of cortisol, or by prolonged use of corticosteroids

Gonads

Hypergonadism

Hypersecretion of hormones by sex glands

Hypogonadism

Hyposecretion of hormones by sex glands

Gynecomastia

Excessive mammary gland development in males

(gynec/o: female; mast: breast)

Diagnostic Procedures Related to Endocrine System

Thyroid gland

Radioactive iodine uptake test

Administration of oral radioactive iodine to measure thyroid function

Thyroid-stimulating hormone assay

Measures circulating blood level of TSH

Thyroid scan

Use of nuclear medicine to measure thyroid function

Diagnostic Procedures Related to Endocrine System

Diabetes mellitus

Fasting blood sugar

Measures blood glucose levels after patient has not eaten for 8–12 hours

Oral glucose tolerance test

Commonly used to diagnose gestational diabetes

Home blood glucose monitoring

The Case of the Sweaty Salesman Case Study Assignment

Method of measuring blood glucose levels multiple times per day

Diagnostic Procedures Related to Endocrine System

Random blood glucose test

Measures blood glucose level (without fasting)

Hemoglobin A1c testing

Measures average blood glucose level over the previous 3–4 months

Fructosamine test

Measures average blood glucose level over the previous 3 weeks

Treatment Procedures Related to Endocrine System

Pituitary gland

Human growth hormone

Synthetic version of growth hormone administered to stimulate growth

Hypophysectomy

Removal of abnormal glandular tissue

(hypophy: pituitary gland)

Treatment Procedures Related to Endocrine System

Pineal gland

Pinealectomy

Surgical removal of pineal gland

Treatment Procedures Related to Endocrine System

Thyroid gland

Antithyroid drug

Medication that slows the ability of thyroid gland to produce thyroid hormones

Radioactive iodine treatment

Oral administration of radioactive iodine to destroy thyroid cells

Treatment Procedures Related to Endocrine System

Thyroid gland

Lobectomy

Surgical removal of one lobe of thyroid gland

(May also refer to removal of a lobe of the liver/brain/lung)

Synthetic thyroid hormones

Oral medication for the replacement of thyroid function

Treatment Procedures Related to Endocrine System

Parathyroid glands

Parathyroidectomy

Surgical removal of one or more parathyroid glands

Treatment Procedures Related to Endocrine System

Thymus

The Case of the Sweaty Salesman Case Study Assignment

Thymectomy

Surgical removal of thymus gland

Treatment Procedures Related to Endocrine System

Pancreas

Pancreatectomy

Surgical removal of all or part of the pancreas

Total pancreatectomy

Treatment for pancreatic cancer

Involves removal of spleen, gallbladder, common bile duct, and portions of small intestine and stomach

Treatment Procedures Related to Endocrine System

Adrenal glands

Laparoscopic adrenalectomy

Surgical removal of one or both adrenal glands

Cortisone

Administered to suppress inflammation or as an immunosuppressant

Answers to Learning Exercises

Chapter 13 Answers

Matching Word Parts 1

13.1 adren/o

13.2 acr/o

13.3 gonad/o

13.4 -dipsia

13.5 crin/o

The Case of the Sweaty Salesman Case Study Assignment

Matching Word Parts 2

13.6 -ism

13.7 pancreat/o

13.8 parathyroid/o

13.9 pineal/o

13.10 pituitar/o

Chapter 13 Answers

Matching Word Parts 3

13.11 somat/o

13.12 poly-

13.13 glyc/o

13.14 thyroid/o

13.15 thym/o

Definitions

13.16 luteinizing

13.17 pituitary

13.18 adrenocorticotropic

13.19 thymus

13.20 calcitonin

13.21 adrenal cortex

13.22 glucagon

13.23 adrenal medulla

13.24 oxytocin

13.25 testosterone

Chapter 13 Answers

Matching Structures

13.26 pancreatic islets

13.27 pituitary gland

13.28 pineal gland

13.29 adrenal glands

13.30 thyroid gland

The Case of the Sweaty Salesman Case Study Assignment

Which Word?

13.31 acromegaly

13.32 anterior

13.33 insulin resistance

13.34 diabetes insipidus

13.35 Cushing’s syndrome

Chapter 13 Answers

Spelling Counts

13.36 luteinizing

13.37 mellitus

13.38 myxedema

13.39 progesterone

13.40 thymosin

The Case of the Sweaty Salesman Case Study Assignment

Abbreviation Identification

13.41 adrenocorticotropic hormone

13.42 antidiuretic hormone

13.43 diabetes mellitus

13.44 fasting blood sugar

13.45 follicle-stimulating hormone

Chapter 13 Answers

Term Selection

13.46 thyroid storm

13.47 hypercalcemia

13.48 parathyroid

13.49 prolactinoma

13.50 fructosamine

Sentence Completion

13.51 electrolytes

13.52 thyroxine

13.53 retinopathy

13.54 polyphagia

13.55 exophthalmos

Chapter 13 Answers

Word Surgery

13.56 hyper-, pituitar, -ism

13.57 hypo-, glyc, -emia

13.58 hyper-, insulin, -ism

13.59 gynec/o, mast, -ia

13.60 hypo-, calc, -emia

True/False

13.61 False

13.62 True

13.63 False

13.64 False

13.65 True

Chapter 13 Answers

Clinical Conditions

13.66 antidiuretic

13.67 polydipsia

13.68 Addison’s disease

13.69 insulinoma

13.70 Hashimoto’s disease

13.71 anabolic

13.72 leptin

13.73 cretinism

13.74 gigantism

13.75 pancreatectomy

Chapter 13 Answers

Which Is the Correct Medical Term?

13.76 neurohormones

The Case of the Sweaty Salesman Case Study Assignment

13.77 pituitary adenoma

13.78 Graves’

13.79 diabetic coma

13.80 melatonin

Challenge Word Building

13.81 adrenopathy

13.82 endocrinology

13.83 adrenomegaly

13.84 thymopathy

13.85 thyroiditis

13.86 pancreatotomy

13.87 thyroidotomy

13.88 pinealopathy

13.89 insulinemia

13.90 adrenitis

Chapter 13 Answers

Labeling Exercises

13.91 pineal

13.92 parathyroid

13.93 thymus

The Case of the Sweaty Salesman Case Study Assignment

13.94 ovaries

13.95 hypothalamus

13.96 pituitary

13.97 thyroid

13.98 adrenal

13.99 pancreatic

13.100 testicles

The Case of the Sweaty Salesman Case Study Assignment