A 55-year-old woman presented with fatigue, headaches, nausea, vomiting, diarrhea, vertigo, weight loss, abdominal pain, and excessive salivation. Her physical examination revealed swollen eyelids, partial limb paralysis, increased skin pigmentation on palms and soles, and white bands on fingernails. Laboratory results showed low ATP production, high arsenic levels, and abnormal cell death due to lack of ATP. She was diagnosed with mitochondrial malfunction due to the low ATP production and cell death not caused by programmed cell death. It was determined that her significant other had poisoned her with arsenic, likely due to previous marital stress and newly acquired wealth from a lottery win.

1. PRESENTED BY:
LARISA HELEN MAHAGA-AJALA
MARIA WATERHOUSE
NICOLE LEE
MARVI CRUZ
Case two

2. Patient History
55 year-old female
 Had excellent health up to date.
Psychological stress
 Marital stress.
 Recently won lottery.

3. Recent Medical Problems
Fatigue
Headaches
Nausea
Vomiting
Diarrhea
Vertigo
Weight Loss
Abdominal pain
Excessive salivation

4. Physical Examination
Swollen eyelids
Partial limb paralysis
Increased pigmentation of skin on palms and soles
White banding on fingernails
Muscle weakness

5. Laboratory Results
Low levels of ATP production
Unusually high levels of arsenic
Abnormal levels of cell death due to lack of ATP

6. Diagnosis
Malfunctioning organelle: Mitochondria
 Reasons:
 Low levels of ATP production.
 High levels of cell death that weren’t caused by programmed cell
death but because of low production of ATP.
 ATP is produced in the mitochondria.

7. What Causes the Other Symptoms?
The significant other of the patient poisoned her
with arsenic.
Psychological rationale:
 Previous marital stress.
 Reason to kill because of newly obtained wealth from the
lottery the patient won.

8. Rationale (cont.)
Using information from physical
exaheadachesmination/symptoms
 From arsenic poisoning, possible symptoms include (but are
not limited to):
 Pigmentation of skin as show from previous picture.
 Muscle atrophy; explains the partial limb paralysis and muscle
weakness.
 Gastrointestinal disorders; explains pain in abdomen.
 Accompanied by: nausea, profuse sweating, diarrhea, and
vomiting.
• The vomiting could have also led to weight loss.
 Other symptoms because of dehydration and loss of salts:
 Dizziness (vertigo) and.