endocrine system hormone case study analysis worksheet

What's Wrong with Timothy? - A Case Study on the Endocrine System

Part 1: As a Teenager.....

Timothy was always an active little boy, and was a great player for his Little League team at the age of 12.   For the first year or so,  Tim had no trouble catching balls and running bases.   He was doing such a good job that he was even promoted to the next division.  Unfortunately, this is also about the time that his mother started to notice that something wasn’t quite right with Timothy.

At age 14, Tim started to have trouble with his coordination and was slower in practice.   His mother wasn’t sure if maybe he was just getting bored with playing.  His coach had no choice but to place him on the bench, he just wasn’t keeping up.   

He started to grow rapidly, and complained about pain in his joints.   Family members just chalked it off to “growing pains.”    Teachers observed that Tim seemed withdrawn, and even his grades began to slip.   In junior high, many of the other boys were showing an interest in girls, but not Tim, he just became more introverted.

By the time Tim entered high school, he was very tall for his age.  At 6’2”, Tim weighed 155 pounds and wore a size 13 shoes.  Some of the kids teased him and called him “stringbean.”    Even after Tim actively tried to put on weight and muscle mass by going to the gym after school, he just couldn’t seem to gain a pound.  Tim’s grades were still not good, and he said he always felt anxious and jittery in school.   Tim would often stay home because he felt sick to his stomach, though his mom thought that some of his symptoms might be due to being overwhelmed with his schoolwork.   His mother finally decided to take Tim to the doctor to see if there was anything physically wrong with him.

Dr. Thalmus made some initial observations of Tim and asked about his symptoms.  He decided to check Tim’s blood to see if his hormone levels were in the normal range.  He first focused on the thyroid, since that is the gland often associated with metabolism.  

1. List Tim'’s symptoms and identify the organ system (or specific organ) associated with those symptoms. (Your may need to reference other materials to identify associated organs and systems.)

2.  Where is the thyroid?   What is the relationship between metabolism and the thyroid?

3.  What is hyperthyroidism? What symptoms of Timothy might suggest he has this disorder?

4. The doctor also decides to check on Timothy’s cortisol levels.    What gland(s) produce cortisol? 

Part 2: The Test Results

The doctor returned to show Timothy the results of his tests. Hormone levels were checked for Thyroid Stimulating Hormone (TSH), Thyroxine (T4) and Tri-iodothyronine (T3).

Dr. Thalmus shook his head at the results, clearly he was puzzled by some of the numbers.  It looks like you may have a condition called hyperthyroidism.  We are going to need to get your TSH numbers higher to correct the problem.

Dr. Thalmus seemed impressed that he knew this and attempted to explain.  “The whole system is part of a feedback loop with your pituitary gland.”    The doctor sketched a quick diagram on the whiteboard in his office. “First, your pituitary senses the level of thyroid hormone in your blood, if the amount is low, then it releases  Thyroid Stimulating Hormone to stimulate the thyroid to release more thyroid hormone.  Basically, the pituitary is attempting to return the system to a normal functioning.

Timothy looked a the diagram and nodded while the doctor continued, “If your thyroid is overactive and producing too much hormone, then the pituitary senses this and slows or shuts down the production of TSH.”

The doctor started writing a prescription. “This drug will suppress your thyroid and hopefully, your pituitary will notice the levels have dropped and will start producing more TSH to get you into the normal range.”

5.  Which hormones would be considered in the high range? What gland produces these hormones? 

   Which hormones would be considered low? What gland produces these hormones?

6.  The doctor didn’t mention cortisol, but it should also follow a similar feedback loop.    Sketch a feedback loop that includes the hypothalamus, pituitary, adrenal glands, and cortisol. 

Part 3: Symptoms Return

Timothy filled his prescription and for several years, his symptoms were alleviated.  When he was 28 years old, two years after getting married, he started noticing other problems.  Anxiety levels were extreme and he had gained so much weight he was almost 250 pounds.    His wife wanted to have children, but she had not yet gotten pregnant.  Tim wondered if maybe his medication needed adjustment, so he returned to Dr. Thalmus.

Dr. Thalmus also noted that Timothy had very sparse body hair, so he also checked Tim’s testosterone levels and ran a battery of tests to see his other  hormone levels.    When the results came in, Dr. Thalmus had some frightening news for Timothy.

“Your hormone levels are all over the place,”  He said.   “Levels of testosterone are extremely low..  Your thyroid hormones are borderline low, but that could be due to medication.   Your cortisol levels are off the chart though. This doesn’t look like it’s just a problem with your thyroid.   I want to check your pituitary gland.”

Timothy frowned.  “Isn’t that in my brain?”    Dr. Thalmus nodded.  “A simple MRI should tell us if there is anything abnormal.”

The results of Timothy’s MRI  showed a mass on his pituitary gland and no major problems with the thyroid.  Could Dr. Thalmus have gotten the diagnosis wrong years ago?  The new symptoms all indicated that a  tumor had put pressure on the pituitary and disrupted its functions.  Tim was referred to a hospital in St. Louis, where they used radiation to destroy the pituitary and any tumor associated with it.

7.   The pituitary gland is called the “master gland.”     What other endocrine glands would have been affected by its malfunction?

8. Tim will need to take several hormone replacements because he no longer has a functioning pituitary gland. Which hormones should the doctor prescribe to Tim?

9.  Dr. Thalmus suggested that Tim take a regimen of Human Chorionic Gonadatropin (HCG), which has the same effects as Luteinizing Hormone (LH)  Why would he recommend this?   What problem will could this potentially solve for Tim?

10.  Do you think the original diagnosis was wrong?  Why or why not?

Anatomy Unit on the Endocrine System

Feedback Loops Worksheet  or  Slides Version

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Endocrine System Hormone Case Studies Analysis

Health care - university/college preparation, high school - canada, yorkdale secondary school - toronto-on.

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Name ______________________________________________ date ________________________________ period ______________, endocrine system hormone case study analysis, directions: read each case study and determine which hormone(s) are responsible. in the last column, signify whether the hormone was hyper-­‐ or hypo-­‐secreted. use the hormones below to help you decide, the correct answer. hormones will be used more than once, and each case study could have more than, hormone responsible., antidiuretic hormone (adh) calcitonin, epinephrine estrogen, follicle-­‐stimulating hormone (fsh) glucagon, growth hormone (gh) insulin, luteinizing hormone (lh) oxytocin, parathyroid hormone (pth) prolactin, progesterone testosterone, thyroid stimulating hormone (tsh) thyroxin, case study hormone(s) hyper- / hypo-, 1 a woman is not able to produce enough, milk for her newborn baby., prolactin hypo, 2 jonathon is extremely short for his age. gh hypo, 3 ron skipped breakfast. he started to, feel confused and dizzy, and then, passed out., glucagon hypo, 4 sarah has drunk 2 liters of water, but, she hasn’t urinated yet., 5 ashley is 17 and hasn’t menstruated, progesterone, 6 a goiter is palpated, inferring the, patient is not getting enough iodine, through their diet., thyroxin hypo, 7 it’s molly’s 40 th week of pregnancy., she’s wondering why she hasn’t, experienced any contractions yet., oxytocin hypo, 8 jerry is experiencing low libido,, decreased sperm production, and low, testosterone levels., 9 tom’s heart rate increases when a, panic attack is coming on., epinephrine hyper, 10 joseph is a stunt man. he’s never, broken a bone; the doctor tells him his, has extremely strong bones., 11 newborn darrell is loosing weight. the, doctor fears he may not be getting, enough nutrition. the pediatrician, recommends to mom to start, supplementing her breast milk with, 12 lexi eats a bag of m&ms, but 2 hours, later her blood sugar is sill high., insulin hypo, 13 delania goes to the gynecologist, because she is having heavy menstrual, flow each month. the doctor performs, an ultrasound and finds her uterine, lining to be very thick., estrogen hyper, 14 luis just had an accident while driving., he’s ok, but his fight-­‐or-­‐fight response, has been activated., 15 keith has high blood sugar even, without eating for hours., 16 chase went to the doctor, because he is, eating healthy foods and exercising, regularly. however, he is still gaining, 17 maya’s menstrual cycle is irregular., one cycle can be 22 days, while the, next cycle can be 39 days., progesterone hypo, 18 jordan is appearing to take on male, secondary sex characteristics as he’s, reaching puberty. he’s starting to, show excessive body hair and, increased muscle mass., testosterone hyper, 19 rachel has just recently found out that, she is infertile. after extensive testing,, the doctors found that her ovaries are, not maturing an egg., 20 angie goes into the doctor with, symptoms of fatigue, depression, and, osteoporosis. the doctor thinks is, could be hypothyroidism., © brilliant biology 2018, 34 ricky goes into the dentist. he is, anxious, nervous, and can’t settle down., his mom has to take him home because, he can’t be calm., 35 a man came into the doctor talk about, his erectile dysfunction and developing, 36 michael and his wife have been trying, to have children for 2 years. michael, went to be tested and found his sperm, count is abnormally low., testosterone, 37 freddie is experiencing muscle cramps,, tingling fingers, and abdominal pain., 38 destiny was rushed to the emergency, room while labor. her contractions, were very close together, and she, delivered the placenta very quickly., oxytocin hyper, 39 jill has type 1 diabetes. she constantly, has high levels of blood glucose., 40 imari is struggling with osteoporosis, and has fragile bones., 2 jonathon is extremely short for his age., 21 alice produces enough milk to feed her, baby and to donate some to the local, hospital for mothers that don’t produce, enough milk., 22 steve is experiencing pain in his lower, back. he goes to the er, and finds out, that he has kidney stones. doctors do a, blood assay, and find that he has, elevated blood calcium levels., 23 kenzie has been drinking the, recommended 64 oz. of water daily, but, the frequency of urination has, 24 raphael is experiencing symptoms like, shaky hands, clumsiness, and a feeling, of hunger. he said the symptoms came, on quickly., 25 adrian is constantly fatigued and he, has gained weight., 26 lisa is extremely tall for her age, while, both of her parents are of average, 27 in a thyroid blood panel that peyton, had completed, the results showed that, he had too much thyroxin in his, bloodstream., 28 kaylee is 16 and is involved in, gymnastics. she is not showing any, signs of secondary sex characteristics., 29 shana is having a hard time getting, pregnant. she just found out that she, hasn’t be ovulating., 30 caleb has been 5’9 since he was 12, and, hasn’t grown since then., 31 sabrina is consistently producing more, than one egg for each menstrual cycle., 32 no matter how much water emily, drinks, she is still dehydrated and, 33 luke has started to loose weight, despite eating more than his usual, caloric intake., 9 epinephrine hyper, 10 calcitonin, 11 prolactin hypo, 12 insulin hypo, 13 estrogen hyper, 14 epinephrine hyper, 15 glucagon, 16 thyroxin, 17 progesterone hypo, 18 testosterone hyper, 19 fsh hypo, 21 prolactin hyper, 22 calcitonin, 23 adh hypo, 24 glucagon hypo, 25 thyroxin, 26 gh hyper, 27 tsh hyper, 28 estrogen, 31 fsh hyper, 32 adh hypo, 33 thyroxin hyper, 34 epinephrine hyper, 35 estrogen hyper, follow me for announcements on new, product listings, updates, newsletters,, and sale promotions., created by brilliant biology, © ashley reis “brilliant biology” 2018, all rights reserved by author., this document and any parts therein are, for personal classroom use only. this, document or any parts therein may not be, electronically distributed or posted on, any website (including school or personal, websites). doing so violates the digital, millennium copyright act..

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Subject : Health Care - University/College Preparation

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