TS is 67 years old with a long history of knee osteoarthritis for which he self-medicates regularly with over-the-counter (OTC) naproxen.

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Read the following case study and answer all of the questions that follow:

TS is 67 years old with a long history of knee osteoarthritis for which he self-medicates regularly with over-the-counter (OTC) naproxen. He is in the clinic today complaining of a swallowing difficulty that has progressively worsened over the past several months. He has otherwise been healthy and has not seen a doctor in many years.

TS denies significant past medical history. A review of systems is negative except for arthritic symptoms and swallowing difficulty. He denies noticing blood in his stool and vomiting blood. He denies history of gastroesophageal reflux disease (GERD) and ulcer.

He does not drink alcohol, although he drank heavily many years ago. He does not smoke. TS describes the dysphagia this way: “Food gets stuck in my throat, and I can’t get it down.” The feeling occurs only after he has ingested solid food; liquids are not a problem. There is burning chest pain associated with meals.

He is scheduled for an upper gastrointestinal endoscopy.

  1. What is the likely cause of his dysphagia?
  2. What advice should TS be given regarding his OTC medication at this time?
  3. What are the usual signs and symptoms of GERD? How will it be managed?
  4. Use scholarly sources for the answers/findings and citations

 

 Read the article, and then answer the questions that follow: 

Soriano S., Alonso-Magdalena P., Garcıa-Arevalo M., Novials A., & Muhammed S. J. (2012). Rapid insulinotropic action of low doses of Bisphenol-A on mouse and human islets of langerhans: Role of estrogen receptor b. PLoS ONE 7(2): e31109. doi:10.1371/journal.pone.0031109

  1. What are the causes of type 2 diabetes?
  2. What is the relationship between insulin resistance and hyperinsulinemia?
  3. What are endocrine disrupters and what are their functions in our body? Provide some examples.
  4. How does concentration of glucose effect insulin secretion?
  5. Explain how data from article support or refute the hypothesis that endocrine disrupters can change insulin secretion.

Be sure to cite the article in text. Paraphrase key points from the article that support your answers.