# Case 2: The Bloated Mrs. Blanc Your next call is to the home of Mrs. Blanc. As before, you have three witnesses to interview. Witness statements: - Ms. Magenta: "Between you and me, she's really let herself go. She has fat deposits in all of these strange places, like around her face and trunk, and a weird hump on her back. If you ask me, some exercise may do her some good!" - Col. Lemon: "Not that I want to talk about such things, but she's seemed bloated, a bit swollen, lately. She even told me that her blood pressure has gone up!" - Ms. Feather: "The poor dear. She's been sick so much lately with all kinds of infections. Personally, I think her immune system needs boosting. But my herbal teas don't seem to help." What are your initial thoughts, based upon the witnesses' statements? Does one hormone come to mind that could produce these effects? Your next step is to speak with Mrs. Blanc. During the interview you notice a bottle of pills on her nightstand. You log the pills as evidence and send them off to the lab for analysis. The lab report shows the pills to be the medication prednisone, which you know to be a glucocorticoid similar to the hormone cortisol. Is this finding significant? Why or why not? Based upon the witness statements and the laboratory analysis, what is your final diagnosis? Explain your reasonin
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Answer

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Step 1
: Examine the witness statements and consider the possible hormonal implications.

The witnesses describe Mrs. Blanc as having fat deposits in strange places, being bloated, having high blood pressure, and suffering from infections. These symptoms could be related to an issue with the hormone cortisol. Cortisol is a glucocorticoid steroid hormone that plays a crucial role in the body's response to stress. It helps to regulate metabolism, immune response, and blood pressure.

Step 2
: Analyze the lab report and its significance.

The lab report indicates that the pills found at Mrs. Blanc's home are prednisone, a glucocorticoid similar to cortisol. This finding is significant because long-term use of glucocorticoids like prednisone can lead to side effects that align with the symptoms described by the witnesses. These potential side effects include: - Weight gain or redistribution of body fat (particularly to the face, neck, back, and waist) - High blood pressure - Suppressed immune system function, increasing the risk of infections

Final Answer

Mrs. Blanc's symptoms and the lab report suggest that she may have been taking prednisone for an extended period. The potential side effects of long-term prednisone use align with the symptoms described by the witnesses. It is essential to consider the possibility that Mrs. Blanc's hormonal balance has been affected by the medication, leading to these issues. Consulting with her healthcare provider to discuss alternative treatments and monitoring her condition is recommended.