Case 1
A 66-year-old male complaining of chest pain is brought to the emergency room by ambulance. The
pain began six hours ago and has become more severe over the past hour prompting him to call
emergency services. He describes the pain as retro-sternal, pressure-like, and non-radiating. He had
some mild dyspnea and nausea accompanying the pain. He has also noted intermittent palpitations
since last evening.
He has a past medical history of hypertension (not currently under treatment) and tobacco use of
one pack per day of cigarettes for the past 47 years. Vital signs on arrival to the emergency room
show a blood pressure of 160/100 mmHg, a heart rate of 92 beats per minute, and a respiratory rate
of 18 per minute. His physical exam is unremarkable. He reports no allergies and no medication use.
Both EKG and cardiac enzymes are pointing towards “anterolateral infarction”. At hospital he got
thrombolytic treatment. In the first 4-5 hours post-thrombolytic treatment his chest pain and other
sign and symptoms were disappeared. However, two days after the onset of the chest pain he had a
cardiac arrest and died. His cardiac pathology image is seen here:
1)
2)
3)
4)
5)
What event is MOST LIKELY associated with this patient’s chest pain?
What type of cell injury was happened in patients’ myocyte? Was it reversible or irreversible?
What kind of cell injury is observed in the above picture? Explain your observation
According to Selye which stage was he situated in before coming to ER?
What of reason/s do you think this patient died of despite proper treatment
Case 2
J.F. is a 26-year-old woman in the clinic today for her annual physical examination. As you take her
medical history, it becomes apparent that she is quite concerned about her risk for developing breast
cancer. Her mother and a maternal aunt both developed breast cancer in their late 40s. J.F. has heard
that genetic testing can be done to see whether she carries “breast cancer genes.”
Discussion Questions
1. Assuming J.F. is talking about the BRCA1 and BRCA2 genes, explain the role that these genes have in
the genetic mechanisms of breast cancer.
2. If genetic testing reveals that J.F. does carry the BRCA1 gene, what does this mean for her risk of
developing breast cancer?
3. What proportion of breast cancer cases can be attributed to inherited forms?
4. What other cancer would J.F. be at risk for given the presence of the BRCA1 gene? How significant is
that risk?
5. What other risk factors should be investigated to evaluate J.F.’s risk for breast cancer?