5PHYM001W Medical Physiology

Case 2 Digestive System

Amanda Carter is a 48 year-old teacher and mother of 3. She has struggled with her weight for much of her life and has tried a variety of diets but is happy that her recent high protein diet is helping and her BMI has reduced from 31 to 28.

Amanda had been experiencing episodes of nausea, bloating and stomach ache for some time. She noticed that her urine was dark and her stools were pale and unusually smelly and were difficult to flush away.

One day whilst at work she became so ill that her colleagues called an ambulance. Clinical examination by the Accident and Emergency doctor observed acute abdominal pain which radiated to her right shoulder accompanied by vomiting. pyrexia and a yellow tinge to the skin and sclera.

Urine testing showed bilirubinuria

Blood bilirubin was raised at 120µmol/l

Amanda was referred to the gastroenterology team. Further tests indicated a diagnosis of Cholelithiasis.

Additional Reading

Sanders G. & Kingsnorth A.N. 2007. Gallstones. BMJ. 335: 295-9

Widmaier,E.P., Raff, H. and Strang, K.T. (2016) Vander’s Human Physiology: the mechanisms of body function, 14th edition, McGraw-Hill International.

Chapter 15 P556 will help them answer these, combined with their L4 notes