Questions 1. What is abnormal about Nick's blood work? Sodium levels Nick's Potassium was were the normal range Over abnormally low, triiodothyronine was substantially high, and his thyrovine levels. His Thyroid drastically low. stimulation Hormone was ily Problems" by Millas, Musey, Duwan, & Stephens 2. In healthy individuals, cells in the hypothalamus secrete Thyrotropin Releasing Hormone (TRH), which stimulates cells in the anterior pituitary to secrete Thyroid Stimulating Hormone (TSH). TSH then stimulates the thyroid gland to secrete T3 and T4, which inhibit TSH secretion, producing a negative feedback system. The data show that, in Nick's case, the level of TSH in the blood is very low. However, despite the lack of stimulation by TSH, the thyroid is secreting abnormally high amounts of T3 and T4 into the blood. Overall T3 an T4 increase the number and activity of the Na/K-ATPase pumps in the cell membranes. Predict the impact that increased activity of the Na/K-ATPase pumps would have on Na+ and K+ concentration gradients. Page 7

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Question 2
Part IV-What Is Nick's Problem?
Nick was admitted and the doctor ordered blood work.
"Okay Nick, have there been any major changes in your diet or life style recently?"
"No, I really haven't had any changes at all. I eat the same food and go to the gym regularly. I've noticed I've felt
unusually tired after the gym and have been sleeping longer than normally."
The doctor nodded, "Have you felt any muscle weakness or drowsiness while you were at the gym?"
"Yes. I feel tired when I've finished exercising," replied Nick. "But then who doesn't leave the gym feeling tired? I'm try-
ing to strength train, but I haven't gotten anywhere. I've lost a few pounds so I assume that I am doing something right."
"Okay. I want to run some tests to try to identify what caused your paralysis."
Table 3-A Partial List of Nick's Vital Signs
Vitals
Blood Pressure
Pulse Rate
Temperature
Nick
88/58 (Hypotension)
52 bpm (Bradycardia)
99.2 °F
Table 4-A Partial List of Results from Nick's Blood Work
Measurment
White Blood Cell Count
Sodium (mm)
Potassium (mm)
Triiodothyronine (T) (ng/dL)
Tetraiodothyronine or thyroxine (T) (ng/dL)
Thyroid Stimulation Hormone (TSH) (ng/dL)
Normal
90-120/60-80
60-100 bpm
98.6 °F
ily Problems" by Millas, Musey, Duwan, & Stephens
NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE
Nick
7,800 cells/mm³
148
2.2
300
36
0.01
were
Normal
Questions
1. What is abnormal about Nick's blood work?
over
Sodium levels
Nick's
abnormally
Potassium was
normal range. His
low, triiodothyronine was
drastically low.
substantially high, and his thyrovine levels. His Thyroid
stimulation Hormone
was
4500-10,500 cells/mm³
135-145
3.5-5.2
59-174
4.5-12
0.3-3.0
the
2. In healthy individuals, cells in the hypothalamus secrete Thyrotropin Releasing Hormone (TRH), which
stimulates cells in the anterior pituitary to secrete Thyroid Stimulating Hormone (TSH). TSH then
stimulates the thyroid gland to secrete T3 and T4, which inhibit TSH secretion, producing a negative
feedback system. The data show that, in Nick's case, the level of TSH in the blood is very low. However,
despite the lack of stimulation by TSH, the thyroid is secreting abnormally high amounts of T3 and T4 into
the blood. Overall T3 an T4 increase the number and activity of the Na/K-ATPase pumps in the cell
membranes. Predict the impact that increased activity of the Na/K-ATPase pumps would have on Na+ and
K+ concentration gradients.
Page 7
Transcribed Image Text:Part IV-What Is Nick's Problem? Nick was admitted and the doctor ordered blood work. "Okay Nick, have there been any major changes in your diet or life style recently?" "No, I really haven't had any changes at all. I eat the same food and go to the gym regularly. I've noticed I've felt unusually tired after the gym and have been sleeping longer than normally." The doctor nodded, "Have you felt any muscle weakness or drowsiness while you were at the gym?" "Yes. I feel tired when I've finished exercising," replied Nick. "But then who doesn't leave the gym feeling tired? I'm try- ing to strength train, but I haven't gotten anywhere. I've lost a few pounds so I assume that I am doing something right." "Okay. I want to run some tests to try to identify what caused your paralysis." Table 3-A Partial List of Nick's Vital Signs Vitals Blood Pressure Pulse Rate Temperature Nick 88/58 (Hypotension) 52 bpm (Bradycardia) 99.2 °F Table 4-A Partial List of Results from Nick's Blood Work Measurment White Blood Cell Count Sodium (mm) Potassium (mm) Triiodothyronine (T) (ng/dL) Tetraiodothyronine or thyroxine (T) (ng/dL) Thyroid Stimulation Hormone (TSH) (ng/dL) Normal 90-120/60-80 60-100 bpm 98.6 °F ily Problems" by Millas, Musey, Duwan, & Stephens NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE Nick 7,800 cells/mm³ 148 2.2 300 36 0.01 were Normal Questions 1. What is abnormal about Nick's blood work? over Sodium levels Nick's abnormally Potassium was normal range. His low, triiodothyronine was drastically low. substantially high, and his thyrovine levels. His Thyroid stimulation Hormone was 4500-10,500 cells/mm³ 135-145 3.5-5.2 59-174 4.5-12 0.3-3.0 the 2. In healthy individuals, cells in the hypothalamus secrete Thyrotropin Releasing Hormone (TRH), which stimulates cells in the anterior pituitary to secrete Thyroid Stimulating Hormone (TSH). TSH then stimulates the thyroid gland to secrete T3 and T4, which inhibit TSH secretion, producing a negative feedback system. The data show that, in Nick's case, the level of TSH in the blood is very low. However, despite the lack of stimulation by TSH, the thyroid is secreting abnormally high amounts of T3 and T4 into the blood. Overall T3 an T4 increase the number and activity of the Na/K-ATPase pumps in the cell membranes. Predict the impact that increased activity of the Na/K-ATPase pumps would have on Na+ and K+ concentration gradients. Page 7
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