General information: All health professionals need to be able to communicate and justify their work to a non-specialist audience, which may comprise those involved in policy-making decisions as well as the general public. As you will be aware, the health sciences are often poorly represented by the media. There are plentiful examples of reporting that may be sensationalistic, misleading, biased (e.g. on vaccine safety), inaccurate (e.g. many media sources seem to view the words bacteria and viruses as interchangeable), or all four. Hence, there is a need for, and a potential career in, good writing and communication in the health professional arena.
This assessment involves addressing a series of generic questions in the form of an essay. The questions relate directly to the case studies presented. Key points to note are below:
Your answers must be incorporated into sentences and paragraphs that include facts from the case study.
All answers must be specific for the person in the case study; marks will not be given where your essay does not relate to the person in the case study.
The answers to the questions in the case study must be integrated into an essay, which should include an appropriate introduction and conclusion; your written communication mark will be heavily penalised if a question-answer style presentation will be .
You can present the information in the order that you feel flows best; you don’t have to present it in the order of the questions.
The information you present must be synthesised from reliable sources (e.g. peer-reviewed articles in the scientific and clinical research literature, and textbooks).
Care must be taken in all aspects of the essay, including spelling and grammar.
Do I need to reference my case study essay? Yes, you must include appropriate in-text citations and a reference list in APA style (7th edition). Penalties will be applied as per the marking criteria for inadequate and/or incorrect referencing. Assignment cover sheet: BIOL121 written assessment
Note: (1) The attention of students is drawn to the Academic Regulations, the Student Academic Integrity and Misconduct Policy and the Assessment Policy; all of which are accessible via http://www.acu.edu.au/policy
(2) A de-identified copy of your assignment may be retained for University quality (audit) processes, benchmarking or moderation.
Student name
Student number
Case study
Word count
(Excluding reference list)
DECLARATION OF ORIGINALITY
By submitting this assignment for assessment, I acknowledge and agree that this assignment is submitted in accordance with the University’s Academic Regulations, Assessment Policy and Student Academic Integrity and Misconduct Policy. I also acknowledge and agree that:
(for each statement, check either ‘Yes’, ‘No’ or ‘N/A’ (not applicable), as relevant).
Yes No N/A
I have cited each paraphrase, and where I have used the ideas of others.
I have referenced each image used (except where I created it myself).
I have included a reference list with appropriate details for all the sources used.
No part of this assignment has been written by any other person.
No part of this assignment has been, or will be, inappropriately shared (including sharing online).
A copy of the original assignment is retained by me, and I may be required to submit the original assignment to the Lecturer-in Charge-upon request.
The Lecturer-in-Charge may, for the purpose of assessing this assignment,
• reproduce this assignment;
• authorise the reproduction of this assignment;
• provide a copy of this assignment to another member of the University; and/or
• communicate, or authorise communication of, a copy of this assignment to a plagiarism checking service, such as the “Turnitin” service operated by iParadigms LLC (or such other service utilised by the University at its absolute discretion). I acknowledge that a plagiarism checking service provider may then retain a copy of this assignment on its database for the purpose of future plagiarism checking.
Signature of student: ___________________________________________ Date: ___/___/___
Type your essay here.
• Remember to include an introduction and conclusion to your essay.
• Your responses should NOT be in a question-answer format.
• If you require help with academic writing, in particular conventions you should adhere to when writing an academic essay, please refer to the Academic Skills Unit LEO site.
• Don’t forget to include in-text citations in APA 7th edition format.
• APA formatting conventions have been used in this template. If you require further information, click here for an APA7 Student Paper Setup Guide.
References
• Include your reference list (with appropriate APA 7th edition formatting) here.
• If you require Helpance with APA referencing conventions, please refer to the ACU Library resources and/or the Academic Skills Unit LEO site.
BIOL121 ASSIGNMENT 3: Written assessment
Scenario: David
David is a 41-year-old male, who has made an appointment to see his GP for his biannual health check. He
tells the doctor that he has been feeling “a bit puffed” walking around the course during his weekly game of
golf and that he seems to be urinating more frequently of late. David reports he has gained nine kilos since
his 30th birthday, and his waist measurement has expanded. He laughs this off as “middle-aged spread” and
says his wife tells him he needs to watch what he eats and drink less alcohol. David works as a software
engineer, which he has been finding very stressful of late, and spends a lot of his time in the office sitting in
front of a computer, snacking on his favourite salt and vinegar chips. David and his wife are keen to start a
family but have not yet been successful in conceiving.
On the advice of his doctor, David has been taking aspirin in the evenings for the past 18 months to lower his
risk of heart attack and Zocor® to address cholesterol.
Physical examination:
Height 174 cm
Weight 94 kg
Appearance Neat appearance, overweight, pale
Temperature 37.1◦
C
Blood work Blood type = O+
Blood glucose = 10 mmol/L
Blood Testosterone levels = 154 ng/dL
GnRH = low
BP 155/99 mm Hg
Respiratory rate 19 bpm
Diet Mostly healthy meals. Snacks on high
fat & sugar, processed foods. Heavy
alcohol consumption.
Past patient history Ex-smoker. Regular check-ups every six
months. Cholesterol levels have been
high at the last three check-ups. Takes
Aspirin in the evenings. Gall bladder
removed 5 years ago.
Social status Lives with his wife and mother-in-law.
Sexually active.
Urinalysis:
Blood –
Bilirubin –
Urobilinogen 0.1 mg/dL
Ketone –
Protein –
Nitrite –
Glucose ++
pH 6
Specific Gravity 1.035
Leukocytes –
©ACU 2022 2
All topics and their key points listed below must be discussed in your essay
Topic 1: Reproduction (10 marks total)
David and his wife are keen to start a family but have had no success so far. Considering David’s blood test
results, indicate whether there is need for further investigation. Your discussion should include the
homeostatic regulation of male reproductive physiology and the relevant glands, cells, and hormones. (10
marks)
Topic 2: Respiratory system (5 marks total)
David is late for work and the lift is broken; he must run up six flights of stairs to make it on time.
Describe the gas exchange occurring between David’s blood and the skeletal muscles in his legs. Discuss how
the rate of gas exchange was affected during the run up the stairs (i.e., during exercise). (5 marks)
Topic 3: Digestion/metabolism (8 marks total)
After speaking to his doctor, David has decided to try to lose weight and he going to start a diet…tomorrow.
Tonight, David is enjoying his last high carbohydrate/high fat meal for a while.
Discuss the potential impact of David’s gall bladder removal upon his ability to digest his dinner. (4.5 marks)
State the hormone that is MOST active in maintaining David’s blood glucose levels at this time. Explain your
answer. (3.5 marks)
Topic 4: Pharmacology (7 marks total)
Under the advice of his doctor, David has taken Zocor® tablets each evening for the past 18 months.
Discuss the route of administration, which route the drug is likely to be excreted after administration, and its
likely bioavailability. Justify your response by discussing whether the drug would be subjected to hepatic first
pass. (4 marks)
To help with weight loss, a friend has advised David to drink grapefruit juice with his meals.
As a health care professional, would you consider this to be a good idea for David? In your answer, discuss
the role of the liver in the administration of Zocor and grapefruit juice? (3 marks)
________________
This article will discuss the health of 41-year-old David based on the information provided from his appointment with his general practitioner. Key topics that will be addressed include David’s reproductive health, respiratory and cardiovascular function during exercise, digestion and metabolism, and pharmacotherapy for managing cholesterol. Recommendations will be provided regarding lifestyle changes and further testing or treatment based on analyzing David’s medical history, physical exam findings, and laboratory results through an biomedical lens.
Reproductive Health
David and his wife have been trying to conceive without success, prompting investigation into potential causes. David’s low levels of gonadotropin-releasing hormone (GnRH) and testosterone are concerning for hypogonadism as a factor in their infertility (Liu et al., 2016). GnRH is secreted by the hypothalamus and stimulates the pituitary gland to release luteinizing hormone and follicle-stimulating hormone, which then signal the testes to produce testosterone and sperm (Liu et al., 2016). Low GnRH could impair this hypothalamic-pituitary-gonadal axis regulation and sperm production.
Further fertility testing is warranted to evaluate David’s sperm count, motility, and morphology. Additional hormonal workup including follicle-stimulating hormone, luteinizing hormone, and prolactin levels may provide insight. If hypogonadism is confirmed, treatment options could include clomiphene citrate to stimulate the pituitary or testosterone replacement therapy (Liu et al., 2016). Given David and his wife’s desire to start a family, prompt Assessment and management of any reproductive issues is important.
Respiratory and Cardiovascular Response to Exercise
When David rushed up six flights of stairs to work one morning, his respiratory and cardiovascular systems had to compensate rapidly for the increased demand of physical exertion. During exercise, oxygen delivery to working skeletal muscles must accelerate to facilitate aerobic ATP production (Powers & Howley, 2018).
As David climbed the stairs, his breathing rate and depth increased to enhance gas exchange in the lungs. More oxygen saturated his bloodstream via pulmonary diffusion while carbon dioxide levels rose and were exhaled. Concurrently, his heart pumped more forcefully to deliver oxygenated blood efficiently to leg muscles via cardiovascular conduction (Powers & Howley, 2018). Blood flow and diffusion of oxygen at the muscle cellular level had to intensify to match ATP utilization. This demonstrates how the respiratory, cardiovascular, and muscular systems coordinate acutely during exercise to meet metabolic needs.
Digestion and Metabolism
David’s gallbladder removal five years ago will not impair his ability to digest fats, as the liver continues to secrete bile even without gallbladder storage and concentration. However, he may experience diarrhea if consuming very high fat meals without the buffering effect of concentrated bile (Koziolek et al., 2015). It is advisable for David to eat moderate portions of fat and consume them with meals over an extended period rather than bolusing large amounts at once.
After his high carbohydrate dinner last night, insulin secretion from the pancreas would be most active in maintaining David’s blood glucose within normal limits. Insulin promotes cellular glucose uptake and glycogen, triglyceride, and protein synthesis while inhibiting gluconeogenesis and ketogenesis (Powers & Howley, 2018). This tightly regulated the postprandial rise and fall of blood sugar to prevent hyperglycemia or hypoglycemia. Given the meal composition and timing, insulin was the dominant hormone acutely managing fuel metabolism.
Pharmacotherapy: Zocor and Potential Drug Interactions
Zocor (simvastatin) is an oral lipophilic statin drug prescribed to lower David’s cholesterol levels. It undergoes extensive first-pass hepatic metabolism, resulting in relatively low bioavailability of only 5% (Bertz & Grattagliano, 2015). Most simvastatin is converted to inactive forms in the liver before being excreted in bile and urine.
Grapefruit juice inhibits the cytochrome P450 3A4 (CYP3A4) enzyme in both the liver and small intestine that aids in statin breakdown (Bailey et al., 2013). Co-administering simvastatin with grapefruit juice could significantly increase bioactive drug levels and risk of adverse effects like myopathy. As David’s healthcare provider, I cannot recommend combining these agents. The liver plays a key role in statin clearance, and grapefruit juice interferes with this pathway. David should avoid grapefruit products while taking Zocor to ensure safety and efficacy of his cholesterol-lowering regimen.
Lifestyle Modifications
Based on the assessment, several lifestyle changes are recommended to support David’s health goals. Losing weight through diet and exercise would benefit his cardiovascular and metabolic status. A heart-healthy, calorie-controlled eating plan emphasizing lean proteins, fruits/vegetables, and whole grains is advised. David should limit alcohol intake, reduce stress through relaxation techniques, and establish a regular physical activity routine including 150 minutes per week of moderate activity (Powers & Howley, 2018). Together, these lifestyle modifications can help manage chronic conditions and optimize quality of life.
David’s doctor can provide referrals for nutritional counseling and exercise programs. Monitoring progress with quarterly checkups including repeat labs will help guide treatment. With diligent lifestyle changes and medication adherence, David’s risk factors should improve over time. His healthcare team will continue evaluating fertility options as well if needed. Overall, a multidisciplinary approach focused on diet, exercise, stress management and medical management offers the best chance for success.
Conclusion
In summary, David presents with several interrelated health issues warranting further investigation and treatment. Low testosterone levels may contribute to infertility and warrant fertility testing. Exercise capacity is appropriate but could be improved with lifestyle changes. Gallbladder removal does not impact digestion but may cause diarrhea with high fat intake. Blood glucose is tightly regulated by insulin after meals high in carbohydrates. Simvastatin requires careful management due to interactions with grapefruit juice through the liver’s CYP3A4 pathway. Comprehensive lifestyle modifications including a heart-healthy diet, stress relief, regular exercise and medication adherence can help optimize David’s health and quality of life. His healthcare team will continue monitoring and supporting him through this process.
References
Bailey, D. G., Dresser, G. K., & Arnold, J. M. (2013). Grapefruit–medication interactions: Forbidden fruit or avoidable consequences?. CMAJ: Canadian Medical Association Journal, 185(4), 309–316. https://doi.org/10.1503/cmaj.120951
Bertz, R. J., & Grattagliano, I. (2015). Statins and intestinal cytochrome P450 3A inhibition: A potential interaction with grapefruit juice and other food supplements. Nutrition, 31(1), 123–127. https://doi.org/10.1016/j.nut.2014.07.002
Koziolek, M., Grimm, M., Becker, D., Igel, S., Büning, C., Schneider, A., … Weitschies, W. (2015). Influence of gallbladder in situ or after cholecystectomy on oral lipid digestion and postprandial lipid levels. British Journal of Nutrition, 113(2), 296–305. https://doi.org/10.1017/s0007114514003665
Liu, P. Y., Swerdloff, R. S., Christenson, P. D., Handelsman, D. J., Wang, C., & Bhasin, S. (2016). Rate, extent and modifiers of spermatogenic recovery after hormonal male contraception: an integrated analysis. Lancet (London, England), 388(10050), 1200–1212. https://doi.org/10.1016/S0140-6736(16)30853-9
Powers, S. K., & Howley, E. T. (2018). Exercise physiology: Theory and application to fitness and performance (10th ed.). McGraw-Hill Education.
