New search

Breanna N. Harris
Research Assistant Professor
Biological Sciences
Texas Tech University
A Yellow-Bellied Lawyer?: A Case Study in Liver Physiology

This interrupted case study tells the story of Michael, a Harvard law graduate with a stressful job and a seemingly heavy drinking problem. Students are provided with background information, medical history, and lab results in order to guide them towards determining what is wrong with Michael. This study highlights cirrhosis and the effects of alcohol abuse on the liver. Before beginning the case study, students should have a background in the physiological role of the liver and the breakdown of hemoglobin. Students are asked to use the information provided for them in the case study to gather more information about liver cells and their functions, alcohol, and alcoholic liver damage. Ultimately, using multiple blood tests, the Maddrey's discriminant function (DF) score, and results from a magnetic resonance elastography (MRE), they will diagnose Michael with alcoholic cirrhosis. This case was developed for use in a non-majors physiology course, but could easily be used for a majors class.

All or Nothing: A Case Study in Muscle Contraction

In this interrupted case study, students pose as an intern of a neuromuscular/skeletal specialist and discover how sarin and myasthenia gravis influence muscle function. Students are given background information about the patients and their situations, as well as results from blood tests. Students are asked incremental questions that build on each other with the end goal of students describing the process of muscle contraction, from motor neuron to sarcomere shortening, and learning what happens when parts of that process are disrupted. This activity was developed for use in a physiology course where the majority of the students were pre-medical, pre-nursing, or other allied health majors.

Black and Blue with Love: A Case Study in Blood Clotting

In this directed case study students follow a nurse practitioner and work with a diagnostics team to determine what is wrong with Tristan, an infant who comes to the clinic with multiple bruises. Students are given background and patient history, and are then given results of various blood tests ordered by the diagnostics team. The exercise emphasizes the physiological process of coagulation and the importance of various clotting factors, especially factor VIII. Students will be introduced to results from several blood tests, including: complete blood count, partial thromboplastin time, prothrombin time, metabolic panel, and factor VIII assay. The patient is ultimately diagnosed with severe hemophilia A and the case then introduces students to this disorder, the genetic determinants, the incidence, and ways to manage the disease. The data in this case are real and the story represents the medical history of an actual patient. Originally developed for pre-nursing students, this activity would also be suitable for majors in physiology or pre-medical students; it could also be used in an introductory genetics or biology course.

Cracking the Case: The Relationship Between Bones and Hormones

In this directed case study, students shadow Dr. Lee in diagnosing two patients with osteoporosis. The students are given patient history and an initial panel of test results, which they discuss in small groups. After diagnosis, they are asked specific questions about bone remodeling, bone physiology, and the drugs prescribed by Dr. Lee. The ultimate goal is to understand how osteoporosis developed in Shino Yang (post-menopausal osteoporosis) and Eleanor Davis (glucocorticoid-induced osteoporosis), and to understand the mechanism of action of the prescribed treatments. The case study data are fabricated, but the values provided are within physiological ranges and should thus be a good representation of what students would see in patients with these actual diagnoses. This case study was developed for college-level, pre-nursing students in a non-majors anatomy and physiology course, but would also be suitable for majors physiology, animal physiology, pharmacology, pre-medical or exercise physiology students, or likely any biology students with a basic knowledge of bone remodeling.

I Heart Running: A Case Study on Tachycardia in Sam the Runner 

"I Heart Running" is a case study in which students diagnose the cause of exercise-induced tachycardia in an otherwise healthy, 27-year-old female. The patient, Sam, is a long-distance runner and realizes that her exercising heart rate reaches over 200 beats per minute. As the story of Sam's encounters with her physician develops, students are given results from multiple laboratory tests and detailed patient background information.  Students are guided through the material with a series of questions with the ultimate goal of determining the cause of the exercise-induced tachycardia that Sam experiences. The case study is based on actual laboratory results and was designed for students in an upper-level undergraduate Human Physiology course. In this activity students will learn about heart rate, cardiovascular physiology, and oxygen carrying capacity, and factors which influence these concepts, as they try to diagnose Sam.

Living the Sweet Life: An Internship in Endocrinology

In this directed case study, students assist Dr. Gupta in his endocrinology clinic in diagnosing three patients having problems with blood glucose regulation. In Part I, students are given patient backgrounds and results from laboratory tests generated by a primary care physician.  Students are initially asked to evaluate the data presented, come up with a potential diagnosis, and determine what additional tests they would like to run. In Part II, students are given results of additional tests and guided through the material with a series of questions with the ultimate goal of determining a diagnosis for each patient (Patient 1: Type II Diabetes; Patient 2: Type I Diabetes; Patient 3: Cushing's Syndrome). The case study contains fabricated data, but values are based on realistic physiological ranges and should give students a realistic idea of values they would see in individuals with these conditions. The study was designed for pre-nursing students in a non-majors anatomy and physiology course. Students will learn about insulin, blood glucose regulation, diabetes testing and diagnosis, diabetes management, cortisol, Cushing's Syndrome, and negative feedback.

Thyroid Troubles: A Case Study in Negative Feedback Regulation

In this interrupted case study, students shadow an endocrinologist as she tries to determine what is wrong with Angela Barber. Angela is a middle-aged woman presenting with symptoms suggestive of a thyroid issue. Students are given background information, patient history, and results from thyroid-specific blood tests. The exercise emphasizes the hypothalamic-pituitary-thyroid axis and particularly highlights the role of negative feedback. Students will use results from serum thyrotropin and thyroid hormone level tests, as well as patient symptoms, to come up with a diagnosis. In preparation for the diagnosis, students are asked to compare the endocrine profiles of patients with Graves' disease, Hashimoto's disease, iodine deficiency (primary hypothyroidism), and various tumors. The case was developed for college-level biology majors in a physiology course, but also has been used successfully for pre-nursing students in a non-majors anatomy and physiology course. Thus, this activity would be suitable for majors in physiology or pre-medical students, as well as allied health majors.