1. The mother of a 17 year old girl brings her daughter to the doctor after she
ID: 258241 • Letter: 1
Question
1. The mother of a 17 year old girl brings her daughter to the doctor after she experiences a number of fainting spells and lethargy. The mother states that her daughter eats practically nothing and is obsessed with exercise and losing weight. Her daughter states that she feels fat if she eats more. The girl is 5’6” and weighs 90 pounds. Physical examination shows loose skin folds and an abnormally low percentage of body fat.
A. Explain why she has an abnormally low percentage of body fat. What 3 tests would you recommend to confirm this and what results are you expecting from these tests? Explain why you expect these results.
B. What would you predict her nitrogen balance test will show? Explain why you expect this finding.
C. What vitamin supplements would you recommend that she take? Consider all the pathways that are active in her current state. List these pathways and the cofactors and the corresponding vitamins needed by the enzymes in each of these pathways.
Explanation / Answer
Please find the answers below:
Answer A: As per the symptoms of the patient, following tests are necessary to be conducted:
Answer B: The nitrogen balance test would demonstrate not only the osmolality of the blood, but it would also demonstrate the optimum functioning of the kidneys as well. Since the patient is obsessed with loosing weight, it is very likely that her protein content in the body is getting exhausted. This is corroborated with the observation of loose skin folds and low fat content. Thus, nitrogen balance test would determine the protein metabolism and homeostasis in the body.
Answer C: The intake of vitamin D and E are highly recommended for this patient. This is because the nutritional deficiency can lead to weakened bones and anemic condition can promote irregular menstrual cycle. Further, a complete diet with all vitamins is also highly recommended.
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