Grand Rounds Doctor Activity
Group 1: Our diagnosis is Type 1 Diabetes.
A combination of weight loss, excessive thirst, muscle weakness, and the fact that the patient has had these symptoms since they were born leads us to believe it is Type 1 Diabetes. The patient’s mother has diabetes as well.
Type 1 Diabetes is where your immune cells destroy the beta cells in your pancreas. The beta cells are the ones that make insulin. Insulin is used to get the glucose from your bloodstream to your cells. When you don’t have the insulin you need to move the glucose it builds up in your bloodstream and the cells it should be going to die off. When there is a high amount of glucose in your bloodstream you start to get high blood sugar. High blood sugar can lead to dehydration, weight loss, diabetic ketoacidosis, and damage to your body. Diabetic ketoacidosis is where your cells aren’t getting enough glucose and start to break down your fat cells instead. This process makes ketones. Your liver tries to help out by releasing the sugar it has stored up. This doesn’t help out though because you still can’t get the glucose to your cells without insulin so the sugar just builds up in your bloodstream. This extra sugar combined with the acid ketones is called Diabetic Ketoacidosis which can be deadly if you don’t treat it.
Group 2: Our diagnosis is Type 2 Diabetes.
Some of the symptoms for Type 2 Diabetes include thirst, fatigue, weight loss, slowness of wound healing, sweating excessively, and a rapid heart beat. It also affects the brain and the bladder. Some risk factors that can also affect Type 2 Diabetes are: smoking, stress, little or no exercise, bad diet, and little or too much sleep.
This disease is not hereditary, so the patient’s habits affect the symptoms. Diabetes typically starts with the body struggling to make a “normal” amount of insulin. With Type 2 Diabetes, patients make insulin, but the cells in their body don’t use it as well as they should, so there will be an excess amount of insulin in the body. This is called insulin resistance. As insulin keeps getting built up in your body, it can start affecting major organs, such as your heart, kidneys, eyes, and your nervous system. It can speed up all these organs, causing them to work harder and release more ATP. If the patient doesn’t exercise frequently, it can cause extreme fatigue, thirst, and excessive sweating.
To prevent these symptoms from getting worse, changing some daily habits can help: stop smoking, have a healthier diet, exercise more often, and try to lose weight. The doctor also might prescribe frequent insulin checks, such as insulin shots and checking of blood pressure.
Group 3: Our diagnosis is Cushing’s Syndrome.
Increased facial hair, blue face, acne, buffalo hump, smooth face, slowness of wound healing, and thin skin tell us that the patient has Cushing’s Syndrome. The most common cause of Cushing syndrome is taking too much glucocorticosteroid medicine. Prednisone, dexamethasone, and prednisolone are examples of this type of medicine. Glucocorticoids mimic the action of the body’s natural hormone cortisol. These drugs are used to treat conditions such as asthma, skin inflammation, cancer, bowel disease, joint pain, rheumatoid arthritis. Other people develop Cushing syndrome because their bodies produce too much cortisol. This hormone is made in the adrenal glands. Causes of too much cortisol are:
Cushing disease, which occurs when the pituitary gland makes too much of the hormone ACTH, ACTH then signals the adrenal glands to produce too much cortisol, pituitary gland tumor, tumors of the adrenal gland, tumors elsewhere in the body that produces corticotropin-releasing hormone, tumors elsewhere in the body that produce ACTH.
Group 4: Our diagnosis is Graves’ Disease.
The symptoms that conclude that the patient has Graves’ Disease are huge bulging eyes, rapid breathing, and the ceasing of the menstrual cycle. This is the most common of all thyroid problems. Fortunately, Graves’ Disease can easily go into remission and disappear completely in a few months. If not treated right away, Graves’ Disease can cause complications and even death.
Graves’ Disease occurs when the thyroid gland secretes an excessive amount of hormones that control the body’s metabolism, causing it to go really quickly and fatiguing the patient. The body’s immune system then releases abnormal antibodies that mimic the thyroid hormone, “freaking out” the thyroid hormone production into working non-stop.
Graves’ Disease is thought to be caused by a number of things, but specialists do not know exactly what causes it. We believe that genes plays a role, though women are more likely to get it than men are. Some habits also can affect the symptoms and make them worse, such as smoking. Environmental factors can also affect the disease; ex: stress.
Some tests to determine that the patient has Graves’ Disease are blood tests, a physical exam, an ultrasound, and some imaging tests.
To treat Graves’ Disease, some treatments include: radioactive iodine therapy (take orally; thyroid need iodine to produce hormones, the radioactive iodine destroys the overactive thyroid cells, causing the thyroid to shrink), anti-thyroid medication (can be taken before or after the radioactive iodine therapy), beta blockers (block the effect of the hormones in the body), or surgery that removes a part of your thyroid gland, then taking a medication to supply your body with a proper amount of thyroid hormones. This is not really recommended, because it can cause damage in your vocal chords and/or your parathyroid gland, which can lead to hypoparathyroidism.
Group 5: NA (our group has Hypoparathyroidism)
Group 6: Our diagnosis is Acromegaly.
Some symptoms of Acromegaly include too big hands and feet, too big facial features, coarse skin, constant sweating, fatigue, suddenly husky voice, impaired vision, barrel chest, and no sex drive. It is caused by the pituitary gland in the brain producing too much growth hormone. Acromegaly is caused by prolonged overproduction of GH in the pituitary gland. The cascading of this hormone regulates the physical growth of the body. This malfunction begins in the part of the brain called the hypothalamus. The secretion of GH stimulates the liver hormone called insulin-like growth factor (IGF-l). IGF-l is what actually causes causes tissue growth in the body. High levels of IGF-I signal the pituitary to reduce production of GH. The hypothalamus makes another hormone called somatostatin, which inhibits GH production and release. Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make GH independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease. 95% of people with acromegaly have a benign tumor of the pituitary gland that produces excess GH. Compression of the pituitary and tissue around it can alter production of hormones. Acromegaly is diagnosed by multiple blood tests and observing the GH levels in the blood. It is treated by surgical removal of the tumor, medical therapy, and radiation therapy of the pituitary. The best method is surgery, where the tumor is removed and the pressure on the brain is relieved, which causes the production of hormones to be regulated.
Group 7: Our diagnosis is Turner’s Syndrome.
Turner’s Syndrome occurs in girls, with symptoms like halted growth, heart defects, mouth abnormalities, swollen hands, scoliosis, constant headaches, vomiting, high blood sugar, and learning difficulties. The patient is also born with the disease, but it is not hereditary. The causes of this disease are a malfunction in reproduction. Typically, a girl has two normal X chromosomes. If the girl has Turner’s Syndrome, there is one normal X chromosome, and the second one is either missing completely (classic Turner’s Syndrome) or has abnormalities or is missing partly (mosaic Turner’s Syndrome).
All the symptoms mentioned above can lead to major problems or illnesses in the future, such as: cardiovascular diseases, kidney failure, immune disorders, infertility, and skeletal problems.
There are several exams and tests that can be taken to prove furthermore that the patient has Turner’s Syndrome: MRI’s of the chest, pelvic exams, ultrasounds of the reproductive organs, etc.
There is no known prevention for Turner’s Syndrome, but you can treat it by taking growth hormones, having an estrogen replacement, and if you wish to become pregnant or have children, the patient can always chose to have a donor egg.
A combination of weight loss, excessive thirst, muscle weakness, and the fact that the patient has had these symptoms since they were born leads us to believe it is Type 1 Diabetes. The patient’s mother has diabetes as well.
Type 1 Diabetes is where your immune cells destroy the beta cells in your pancreas. The beta cells are the ones that make insulin. Insulin is used to get the glucose from your bloodstream to your cells. When you don’t have the insulin you need to move the glucose it builds up in your bloodstream and the cells it should be going to die off. When there is a high amount of glucose in your bloodstream you start to get high blood sugar. High blood sugar can lead to dehydration, weight loss, diabetic ketoacidosis, and damage to your body. Diabetic ketoacidosis is where your cells aren’t getting enough glucose and start to break down your fat cells instead. This process makes ketones. Your liver tries to help out by releasing the sugar it has stored up. This doesn’t help out though because you still can’t get the glucose to your cells without insulin so the sugar just builds up in your bloodstream. This extra sugar combined with the acid ketones is called Diabetic Ketoacidosis which can be deadly if you don’t treat it.
Group 2: Our diagnosis is Type 2 Diabetes.
Some of the symptoms for Type 2 Diabetes include thirst, fatigue, weight loss, slowness of wound healing, sweating excessively, and a rapid heart beat. It also affects the brain and the bladder. Some risk factors that can also affect Type 2 Diabetes are: smoking, stress, little or no exercise, bad diet, and little or too much sleep.
This disease is not hereditary, so the patient’s habits affect the symptoms. Diabetes typically starts with the body struggling to make a “normal” amount of insulin. With Type 2 Diabetes, patients make insulin, but the cells in their body don’t use it as well as they should, so there will be an excess amount of insulin in the body. This is called insulin resistance. As insulin keeps getting built up in your body, it can start affecting major organs, such as your heart, kidneys, eyes, and your nervous system. It can speed up all these organs, causing them to work harder and release more ATP. If the patient doesn’t exercise frequently, it can cause extreme fatigue, thirst, and excessive sweating.
To prevent these symptoms from getting worse, changing some daily habits can help: stop smoking, have a healthier diet, exercise more often, and try to lose weight. The doctor also might prescribe frequent insulin checks, such as insulin shots and checking of blood pressure.
Group 3: Our diagnosis is Cushing’s Syndrome.
Increased facial hair, blue face, acne, buffalo hump, smooth face, slowness of wound healing, and thin skin tell us that the patient has Cushing’s Syndrome. The most common cause of Cushing syndrome is taking too much glucocorticosteroid medicine. Prednisone, dexamethasone, and prednisolone are examples of this type of medicine. Glucocorticoids mimic the action of the body’s natural hormone cortisol. These drugs are used to treat conditions such as asthma, skin inflammation, cancer, bowel disease, joint pain, rheumatoid arthritis. Other people develop Cushing syndrome because their bodies produce too much cortisol. This hormone is made in the adrenal glands. Causes of too much cortisol are:
Cushing disease, which occurs when the pituitary gland makes too much of the hormone ACTH, ACTH then signals the adrenal glands to produce too much cortisol, pituitary gland tumor, tumors of the adrenal gland, tumors elsewhere in the body that produces corticotropin-releasing hormone, tumors elsewhere in the body that produce ACTH.
Group 4: Our diagnosis is Graves’ Disease.
The symptoms that conclude that the patient has Graves’ Disease are huge bulging eyes, rapid breathing, and the ceasing of the menstrual cycle. This is the most common of all thyroid problems. Fortunately, Graves’ Disease can easily go into remission and disappear completely in a few months. If not treated right away, Graves’ Disease can cause complications and even death.
Graves’ Disease occurs when the thyroid gland secretes an excessive amount of hormones that control the body’s metabolism, causing it to go really quickly and fatiguing the patient. The body’s immune system then releases abnormal antibodies that mimic the thyroid hormone, “freaking out” the thyroid hormone production into working non-stop.
Graves’ Disease is thought to be caused by a number of things, but specialists do not know exactly what causes it. We believe that genes plays a role, though women are more likely to get it than men are. Some habits also can affect the symptoms and make them worse, such as smoking. Environmental factors can also affect the disease; ex: stress.
Some tests to determine that the patient has Graves’ Disease are blood tests, a physical exam, an ultrasound, and some imaging tests.
To treat Graves’ Disease, some treatments include: radioactive iodine therapy (take orally; thyroid need iodine to produce hormones, the radioactive iodine destroys the overactive thyroid cells, causing the thyroid to shrink), anti-thyroid medication (can be taken before or after the radioactive iodine therapy), beta blockers (block the effect of the hormones in the body), or surgery that removes a part of your thyroid gland, then taking a medication to supply your body with a proper amount of thyroid hormones. This is not really recommended, because it can cause damage in your vocal chords and/or your parathyroid gland, which can lead to hypoparathyroidism.
Group 5: NA (our group has Hypoparathyroidism)
Group 6: Our diagnosis is Acromegaly.
Some symptoms of Acromegaly include too big hands and feet, too big facial features, coarse skin, constant sweating, fatigue, suddenly husky voice, impaired vision, barrel chest, and no sex drive. It is caused by the pituitary gland in the brain producing too much growth hormone. Acromegaly is caused by prolonged overproduction of GH in the pituitary gland. The cascading of this hormone regulates the physical growth of the body. This malfunction begins in the part of the brain called the hypothalamus. The secretion of GH stimulates the liver hormone called insulin-like growth factor (IGF-l). IGF-l is what actually causes causes tissue growth in the body. High levels of IGF-I signal the pituitary to reduce production of GH. The hypothalamus makes another hormone called somatostatin, which inhibits GH production and release. Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make GH independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease. 95% of people with acromegaly have a benign tumor of the pituitary gland that produces excess GH. Compression of the pituitary and tissue around it can alter production of hormones. Acromegaly is diagnosed by multiple blood tests and observing the GH levels in the blood. It is treated by surgical removal of the tumor, medical therapy, and radiation therapy of the pituitary. The best method is surgery, where the tumor is removed and the pressure on the brain is relieved, which causes the production of hormones to be regulated.
Group 7: Our diagnosis is Turner’s Syndrome.
Turner’s Syndrome occurs in girls, with symptoms like halted growth, heart defects, mouth abnormalities, swollen hands, scoliosis, constant headaches, vomiting, high blood sugar, and learning difficulties. The patient is also born with the disease, but it is not hereditary. The causes of this disease are a malfunction in reproduction. Typically, a girl has two normal X chromosomes. If the girl has Turner’s Syndrome, there is one normal X chromosome, and the second one is either missing completely (classic Turner’s Syndrome) or has abnormalities or is missing partly (mosaic Turner’s Syndrome).
All the symptoms mentioned above can lead to major problems or illnesses in the future, such as: cardiovascular diseases, kidney failure, immune disorders, infertility, and skeletal problems.
There are several exams and tests that can be taken to prove furthermore that the patient has Turner’s Syndrome: MRI’s of the chest, pelvic exams, ultrasounds of the reproductive organs, etc.
There is no known prevention for Turner’s Syndrome, but you can treat it by taking growth hormones, having an estrogen replacement, and if you wish to become pregnant or have children, the patient can always chose to have a donor egg.