ChooseONEof the three case studies provided below (click on the hyperlink to access the PDF file).BlairDavidEshmaCarefully read all materials provided for your chosen case study.You will need to...

Introduction:
Eshma is a ma
ied marathon runner who had two teenage children. She had the issues of light-headedness, muscle pain, lethargy and increased heartbeat. She also felt wa
ly on her feet and stumbled while climbing the stairs. To get relief from her muscle pain, she used a non-steroidal drug Emulgel on her calves and quadriceps. She took proper drinks and diet but, because of the low-calorie content, she lost 2 kg of weight in two months and suffered from ameno
hea. Her periods became i
egular. Her last period came before 5 months but it is evident from her blood and urine tests report that she is not pregnant. She has dark circles under her eyes and low blood pressure. Her systolic pressure is 87mm of Hg, diastolic pressure of 58 mm of Hg and respiratory rate of 25 bpm. From urinalysis, it is found that she has acidic urine with urobilinogen content in it. From the physical examination and urine test report her health issues in the given circumstances are analyzed and changes in her reproductive, respiratory, digestive and pharmacology systems are assessed as discussed below.
Discussion:
1.Changes in reproductive system-
It is mentioned that Eshma’s periods are missing from last five months which showed that she has ameno
hea. Menstrual cycle is the result of interlinked activities of different hormones or the chemical signals released from the
ain, ovaries, and uterus [1]. The primary cause of her ameno
hea was hormonal distu
ances, disproportionate exercise, extreme weight loss and reproductive disorders. Her ameno
hea is mainly linked to the change in her glandular tissue endometrium that lines the uterus because of the hormonal imbalance [2]. Endometrium is an epithelial tissue lining with embedded tube-like uterine glands. These glands produce proteins, lipids, and glycogen utilized for the nourishment of an em
yo and avert the endometrium from
eaking down. This layer thickened and provides nourishment to the growing em
yo if pregnancy occurs otherwise sheds as the menstrual blood. Oestrogen and progesterone hormones are mainly responsible for the morphological changes of endometrium. Oestrogen acts via oestrogen receptors and helps in the thickening of endometrial mucosa during proliferative phase while progesterone ats on the progesterone receptors and fix it for secretory phase. And if fertilization not occurs then due to the low-level of these oestrogen and progesterone hormones, the endometrial layers shed and bleeding or menstruation ensues [3]. In case of Eshma, due to her strenuous workouts and low-calorie diet, structural changes occu
ed in the uterine glands that causes the hormonal imbalance. And this altered level of oestrogen and progesterone ultimately resulted in abnormal menstrual cycle or ameno
hea [4].
2.Changes in respiratory system-
Eshma is a marathon runner so for preparing herself for the run, she used to do the strenuous workouts and exercises. For performing these activities, muscles movements are must which specifically requires energy. This energy is produced by the oxygenic or aerobic
eakdown of glucose. To fulfill this demand of oxygen, body performs the
eathing and respiration [5]. In
eathing, air with high concentration of oxygen is inhaled inside while air with high concentration of CO2 is expelled outside. Then in respiration with the help of...