Patient Z tends to be hyperactive and thin. You are an endocrinologist, and you first determine that Z has high thyroid hormone levels in the blood. Your next step is to determine whether the problem lies at the level of the hypothalamus, anterior pituitary or the thyroid gland. What is the predicted level (high, normal, low) for TRH, TSH and thyroid hormone if the problem is:

a) due to a problem with secretion of TRH by the hypothalamus?

b) due to a problem with secretion of TSH by the anterior pituitary gland?

c) due to a problem with secretion of thyroid hormone by the thyroid gland?

Use this framework for your answer:

Condition a) (hypothalamus defect)
TRH levels:

TSH levels:

thyroid hormone levels:

Condition b) (anterior pituitary defect)
TRH levels:

TSH levels:

thyroid hormone levels:

Condition c) (defect at the level of the thyroid gland)
TRH levels:

TSH levels:

Thyroid hormone levels:

Assume that you determine that the problem is high secretion of TSH by the anterior pituitary, despite normal levels of TRH. Describe two possible causes of this problem, and how you could gather evidence for those causes. Assume that you can take small pieces of Xs anterior pituitary gland, keep it alive in a dish, and measure what you need to measure.

Possible cause #1 for high secretion of TSH by the anterior pituitary despite normal TRH:
Experimental evidence that would support this cause: (1 pt).
Possible cause #2 for high secretion of TSH by the anterior pituitary despite normal TRH:
Experimental evidence that would support this cause:

Sample solution

Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell. 

In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.

God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.

Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.

To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.

 

References

Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.

Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies4(8), 487.

Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.

 

Predicted Levels for TRH, TSH, and Thyroid Hormone

Condition a) (Hypothalamus defect)

– TRH levels: Low
– TSH levels: Low
– Thyroid hormone levels: Low

Explanation: If there is a defect in the hypothalamus, TRH (Thyrotropin-Releasing Hormone) secretion would be decreased. This reduction would lead to lower levels of TSH (Thyroid-Stimulating Hormone) from the anterior pituitary and consequently lower thyroid hormone levels.

Condition b) (Anterior pituitary defect)

– TRH levels: Normal
– TSH levels: Low
– Thyroid hormone levels: Low

Explanation: In the case of an anterior pituitary defect, TRH levels would remain normal because the hypothalamus is functioning correctly. However, since the anterior pituitary is unable to secrete TSH effectively, TSH levels would be low, leading to low levels of thyroid hormones as well.

Condition c) (Defect at the level of the thyroid gland)

– TRH levels: Normal
– TSH levels: Normal
– Thyroid hormone levels: High

Explanation: If the defect lies within the thyroid gland itself, the gland may be secreting excessive amounts of thyroid hormones independent of TSH stimulation. TRH and TSH levels would remain normal because they are being produced adequately by the hypothalamus and anterior pituitary, respectively.

Possible Causes of High Secretion of TSH by the Anterior Pituitary Despite Normal TRH

Possible cause #1 for high secretion of TSH by the anterior pituitary despite normal TRH:
Hyperplasia or tumor of the anterior pituitary gland (e.g., a TSH-secreting adenoma) could lead to increased production of TSH independently of TRH levels.

Experimental evidence that would support this cause:
Histological examination of the anterior pituitary tissue could reveal an excess of TSH-secreting cells or a tumor. Additionally, measuring TSH production in vitro from cultured anterior pituitary cells would show elevated levels compared to normal controls.

Possible cause #2 for high secretion of TSH by the anterior pituitary despite normal TRH:
Resistance to negative feedback by thyroid hormones due to mutations in thyroid hormone receptors or other signaling pathways could lead to increased TSH secretion as the anterior pituitary perceives low thyroid hormone action.

Experimental evidence that would support this cause:
Performing receptor binding assays on anterior pituitary cells could demonstrate decreased binding efficacy of thyroid hormones to their receptors. Additionally, measuring downstream signaling responses (such as cAMP levels) in response to normal thyroid hormone concentrations could show blunted responses, indicating receptor resistance.

 

 

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