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EXAMPLES OF CLINICAL SITUATIONS

TO ASSESS FORMATION OF THE FOLLOWING COMPETENCIES

GC-1, GPC-1, 7, 9, PC-5, 12

1. What cells in the female body produce estrogens and progestins? What is the relation between levels of these hormones in the blood and phases of the menstrual cycle? What are their blood levels in pregnancy and what is the significance of their blood level changes? Is it possible to detect progesterone in the male body and why?

2. A climber climbs the mountain top with an effort. Suddenly he feels dizzy, weak, excessive sweat appears. Which metabolic activity is changed? What is it necessary to do in order to improve the person?s condition?

3. Effective medicines for treating many diseases (rheumatism, rheumatoid arthritis, bronchial astma, etc.) are glycocorticoids (hydrocortisone, predniso-lone, etc.). But during treatment the patient may develop symptoms similar to diabetes mellitus. What is the cause of hyperglycemia upon a prolonged administration of glucocorticoids? What is the effect of glucocorticoids on carbohydrate and protein metabolism in the liver, kidneys and other organs and tissues?

4. The woman presents with cholelithiasis complaining of pain in the liver area, icteric coloration of both skin and sclera. The feces are discolored, urine is dark colored. What changes in pigment metabolism do you recognize? What is the type of jaundice?

5. Examination of a patient shows bilirubin blood level of 10 μmol/l; sterco-bilin is detected in both feces and urine, no bilirubin is detected in urine. What is your conclusion about pigment metabolism?

6. Starvation results in a rapid decrease in liver glycogen. But for a long time this sign is not accompanied by decreased concentration of glucose in the blood. How can you explain this phenomenon?

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