Case 3: The Parched Professor Your last call is to the aid of Professor Purple.

Question

Case 3: The Parched Professor Your last call is to the aid of Professor Purple. Thee witnesses are present from whom to take statemenes Witvess statments ear that 1 saw him drink s fhull Jlasof water every half an hour soday, Hc kepe saying how thiesy Mrs Blane "He must be going o the ...well, you know, the litdle boys room, two or thee times every hour!" " Ms. Fearher: "He's been saying lately that his mouth is dry and that he feels weak Personally, I think he's just not following a healthy diet.He should be drinking some of my herbal teas!" Based upon the witnesses produce these effects? Explain. ' statements, what are your initial thoughts? Does one hormone come to mind that could You interview Professor Parple and collect blood and urine specimens to be sent off to the lab for analysis. The lab reports that the urine osmolality is 150 mOsm/kg, which means the urine is overly dilute (too much water in the urine). The blood osmolality is 300 mOsmkg, meaning the blood is overly concentrated (too litle water in the blood). The lab also reports that his blood glucose is completely mormal, What is the significance of these clues? 16 Based upon the witness statements and the laboratory analysis, what is your final diagnosis? (Hint: Think of the hormone that is supposed to trigger water retention from the kidneys. Is there a disease where this hormone is deficient?) Explain Prof. Purple's symptoms. Endocrine System UNIT 16 437

Explanation / Answer

A. Hormone that may be responsible -

B. The urine osmolarity suggest that urine concentrating mechanism of kidney is defective. Therefore excess of water is removed from blood in form of urine (this lead to diluted urine) and excess osmolarity of blood (as more water is removed from blood).

As the blood glucose is normal therefore we can rule out Diabetes Mellitus (a condition in which blood glucose increase secondary to insulin deficiency or insulin resistance). In this condition also we see polyurea (excessive urination) but blood glucose is normal and urine osmolarity is also high.

C. He may be suffering from Diabetes Insipid. In this condition there is either Antidiuretic hormone deficiency or there is resistance to its action. Normally ADH act in kidney and cause water reabsorption thus preventing excess water loss (this maintain plasma and urine osmolarity). There are 2 types of diabetes insipidus -

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