Sheenan Case Study (Unit 2 Exam)

Question 1

What is organomegaly?

Answer 1

Large viscera / organs

Question 2

What do clubbing and cyanosis in the extremities indicate?

Answer 2

Clubbing-chronic pulmonary or Cardiovascular diseases; cyanosis-hemoglobin is poorly oxygenated

Question 3

The type of blood pressure change detailed above is referred to as:?

Answer 3

Orthostatic hypotension

Question 4

Disturbances in what hormone can cause dry skin?

Answer 4

TSH

Thyroid hormones (T3 and T4)

Question 5

What is the scientific name for dry skin?

Answer 5

xerosis or xeroderma

Question 6

Which of Veronica’s physical symptoms indicate she is in a hypothyroid state?

Answer 6

Weight gain,
dry skin
tired
low blood pressure upon standing (orthostatic hypotension)

Question 7

What cell type is responsible for secretion of TSH?

Answer 7

Thyrotrophs

Question 8

If TH works on a cell to affect a change within minutes what type of response is this?

Answer 8

Non-genomic

Question 9

Is thyroid hormone released in response to a signal from a parvocellular or magnocellular neurosecretory neuron?

Answer 9

parvocellular

Question 10

What information above is likely associated with Veronica’s inability to breastfeed?

Answer 10

Low prolactin

Question 11

How does primary hypothyroidism impact PTH secretion and plasma calcium?

Answer 11

Thyroid does not have functional connection with PTH glands = should not impact PTH or Ca2+

Question 12

What appears to be Veronica’s problem(s) based on the results of her blood work and clinical history – what do you think that has been damaged? (be specific)

Answer 12

anterior pituitary/adenohypophysis with hyposecretion of all hormones

Question 13

What is unique about the structure named above that made this structure vulnerable to the type of damage that occurred ?

Answer 13

AP is supplied with low pressure portal system, is more prone to ischemia. Interruption in blood flow– get ischemia – loss of oxygen tissue dies

Posterior pituitary is perfused with high pressure arterial system, it likely experienced a smaller fall in pressure

Question 14

Based on the data in Table 2: which type of replacement therapy might Veronica now need most and which is likely not necessary for her? Please provide rationale for your answer

Answer 14

Needs thyroid replacement or cortisol

Thyroid replacement –
can improve symptoms of thyroid deficiency such as slow speech, lack of energy, weight gain, hair loss, dry skin, and feeling cold

Cortisol to prevent adrenal insufficiency

– not GH since fully grown

Question 15

Do you know the name of this specific syndrome?

Answer 15

Sheehan syndrome