An avid student of GI physiology decides to swallow a marble…
An avid student of GI physiology decides to swallow a marble and trace its path through their gastrointestinal system (this is not recommended). Which of the following structures would be the fourth sphincter that the marble passes through on its way through the GI system?
Read DetailsA 28-year-old man presents with chronic watery diarrhea for…
A 28-year-old man presents with chronic watery diarrhea for 3 months. He reports large-volume stools that persist even during fasting. He denies weight loss or blood in stool. Laboratory evaluation reveals the following stool studies: Stool sodium: 95 mEq/L Stool potassium: 40 mEq/L Which of the following is the most likely mechanism of this patient’s diarrhea?
Read DetailsUse this case to answer the next 4 questions. Presentati…
Use this case to answer the next 4 questions. Presentation Mrs. Bailey is a 32-year-old married mother of 3 healthy children. After she stopped breast feeding her third child, her menstrual periods did not return. Her family physician diagnosed her with polycystic ovarian syndrome (PCOS) and recommended diet and exercise. He also put her on a low dose of metformin. Metformin is a drug that increases insulin sensitivity; insulin resistance has been implicated in the development of PCOS, and metformin is helpful to woman with PCOS. Mrs. Bailey finds the metformin gives her diarrhea, so she stops taking it and decides to concentrate on diet and exercise. Over the next two years she is not successful with the weight loss program. She has not gained weight but seems to be putting on fat around her back and abdomen. She has acne and hair growth on her face. She goes back to her family doctor when she finds she is too weak to pick up her 3-year-old. The family doctor refers her to an endocrinologist. Her exam results are as follows: 5’4” and 155 pounds à BMI of 25.8 (overweight) Blood pressure 142/ 98 mmHg Pulse is 72 bpm Respiratory rate 12/min She has abdominal obesity and thin arms; her hand grip is weak, and her reflexes are reduced in briskness Blood Measurement from serum plasma Result Normal Range Sodium 149 mmol/L 135-146 mmol/L Potassium 3.2 mmol/L 3.5-5.0 mmol/L Chloride 110 mmol/L 97-110 mmol/L pH 7.43 7.36 – 7.44 Calcium (total) 9.9 mg/dL 9.0-10.5 mg/dL Parathyroid hormone 15 pg/mL 10-75 pg/mL Glucose (fasting) 120 mg/dL 70-110 mg/dL Prolactin 3 ng/mL 1.4-24.2 ng/mL Estrogen (midcycle) 131 pg/mL 150-750 pg/mL Total Cortisol 52 ug/dL 10-20 ug/dL morning sample Free Cortisol 5.2 ug/dL 0.3-0.9 ug/dL ACTH 2 pg/L 10-50 pg/mL According to the evidence from Mrs. Bailey’s case, what is the sources of her endocrine disorder?
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