Reference no: EM133917180

Bruce is a 47-year-old journalist, who decides he needs to visit his doctor due to some gastrointestinal symptoms. At first it just started out as a bit of abdominal pain and cramping, followed by diarrhea so at first Bruce just thought he had a stomach bug. But weeks went by and the diarrhea just increased in frequency, and instead of feeling better, he started to feel really fatigued. This had been going on for 8 months before his wife finally convinced him to make an appointment with a doctor, who then referred him to a gastroenterologist. A couple of months later when he finally goes to his specialist appointment, Bruce admits after questioning that he has had bleeding with his stool, but he didn't want to tell the doctor as he was embarrassed and didn't want to get checked for hemorrhoids. The gastroenterologist also asks many questions about Bruce's diet and his weight and discovers that Bruce has lost 15 kg in the past year despite eating a lot of hot chips and mashed potatoes - the only thing Bruce feels doesn't make his diarrhea worse. The gastroenterologist then tells Bruce he would like to perform a colonoscopy to investigate further. After the colonoscopy, the surgeon tells Bruce that they found a number of polyps in his bowel, which is not necessarily a cause for concern as many polyps are benign, but they will have to wait on the results of the biopsies to make sure none of them were malignant. A week later the surgeon calls Bruce; unfortunately, it is bad news - the biopsy shows evidence that the growth is malignant and anaplastic and that they can't rule out metastatic growths. Bruce is called back in for follow-up tests, and they find that there is an abnormal growth in his liver also. Bruce is now sent to an oncologist, who recommends that he has surgery to remove any remaining polyps, a portion of his bowel, and the abnormal growth from his liver. Based on the advice from his oncologist, Bruce also decides to undergo chemotherapy treatment. Whilst doing some routine checks after his treatment, Bruce is informed he has neutropenia.

Questions

1. Describe two similarities and two differences between hyperplasia and cancer.

2. On follow-up examinations, Bruce is found to have a brain tumour. Biopsy results reveal that the cancer cells taken from his brain tumour have the morphological characteristics of colorectal cancer. Considering brain cells are permanent cells, explain the most likely reason for this finding.

3. Explain why patients who have leukaemia may have excessively high numbers of white blood cells in their blood, yet they are immunocompromised. BIOL122 End-of-semester worksheet Semester 2, 2021 Bruce's friend Greg has been trying to support him throughout his journey. Greg is a 42-year old ITspecialist, who suffers from type II diabetes mellitus, which has been under control using an oral anti-hyperglycaemic medication and a reasonably healthy diet. Rather disturbingly, however, Greg has been experiencing numbness and some awkward tingling in his left foot recently.

4. Assuming that Greg's present symptoms are associated with his underlying disease, name the condition responsible for his numbness and tingling, and explain the link between type II diabetes and the condition you identified.

5. Greg takes an oral anti-hyperglycaemic medication. Explain why insulin administration is not recommended in his condition.

6. Explain how glucose uptake of Greg's (i) endothelial and (ii) resting skeletal muscle cells changes when he is experiencing a hyperglycaemic episode and give your rationale.