Case 2-10
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School
Calhoun Community College *
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Course
4
Subject
Medicine
Date
May 24, 2024
Type
Pages
3
Uploaded by jaleasej
Daniel R., a 47-year-old male, went to his physician for an “annual” physical that had been postponed for over 3 years. He had started his own business 4 years ago and had been extremely busy getting it established. Daniel’s medical history indicated he was a nonsmoker, and his father and grandfather had histories of myocardial infarction before age 55. Since the physician had not seen this patient in a number of years, she decided to order routine screening tests. SERUM Patient Test Requisition/Reporting Patient Name: Daniel R. ID 459836 Collection Date/Time_1/26/2021 Dr. Murphy CHEMISTRY/IMMUNOLOGY TEST REFERENCE Patient Interval, SERUM RESULT Na 135-145 mEq/L 143 K 3.5-5.0 mEq/L 4.6 Cl 98-106 mEq/L 104 CO: 24.0-34.0 mEq/L 29.0 BILIRUBIN, 0.2-1.2 mg/dL 0.5 TOTAL CHOLESTEROL | <200 mg/dl 305 GLUCOSE 70-100 mg/dl 95 BUN 6-20 mg/dl 19 CREATININE 0.7-1.4 mg/dl 1.0 Total Protein 6.0-8.3 g/dl 7.5 AST <35 IU/L 35 ALP 30-157 IU/L 70 ALBUMIN 3.5-5.0 g/dL 4.6 CALCIUM 8.5-10.5 mg/dL 8.5 Case modified from Case Studies in Clinical Laboratory Science by Linda Graves
URINALYSIS TEST REFERENCE Patient Interval RESULT PHYSICAL -COLOR Straw-Dark Yellow | Yellow - APPEARANCE Clear Clear -SG 1.005-1.030 1.014 (refractometer) CHEMICAL -GLUCOSE NEGATIVE NEG -BILIRUBIN NEGATIVE NEG -KETONES NEGATIVE NEG -BLOOD NEGATIVE NEG -pH 5.0-8.0 6.0 -PROTEIN NEG-TRACE NEG -UROBILINOGEN | 0.1-1.0 mg/dl NEG -NITRITE NEGATIVE NEG -LEUKOCYTE NEGATIVE NEG ESTERASE Questions 1. Circle or highlight the abnormal result(s). 2. Circle or highlight the patient symptoms that are abnormal/significant. 3. List at least eight secondary conditions/disorders associated with the abnormal result(s) in question 1.
4. Which of the conditions you listed for question 3 can the physician rule out with Daniel’s medical history, physical examination, and current laboratory results? 5. What 1s the most probable cause of the abnormal test results in this patient? The following week, a lipid profile was performed on a 12-hr fasting specimen. LIPID PROFILE TEST REFERENCE INTERVAL, | PATIENT RESULT SERUM CHOLESTEROL 305 Recommended (desirable): <200 mg/dL HDL CHOLESTEROL 45 29-75 mg/dL TRIGLYCERIDES 390 Recommended (desirable): <250 mg/dL 6. Given the above information, what 1s Mike’s LDL cholesterol? 7.Based on his LDL, is he at high risk for coronary heart disease (CHD), moderate risk, or within the recommended/desirable range? 8. If Daniel’s triglycerides were 450 mg/dL, could the LDL be calculated? Why or why not? 8. What risk factors for CHD does Daniel presently have, given the information provided?
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