3. A 15-year-old boy presented with a history of episodic vomiting associated with subacute encephalopathy from the age of one year. There were 2-3 months of asymptomatic periods betwcen the episodes. He was born of non- consanguincous parents at full term had a normal perinatal period with no evidence of birth asphyxia. During the hospitalstay he had 2 episodesofconvulsive seizures. Investigations revealed high blood ammonia (288 ug/dL, normal level is 40-80 ug/dL), markedly elevated levels of citrulline (2200 umoles/L. normal is 1–55 umoles/L), and low blood urea (5 mg/dL, normal is around 7 to 20 mg/dL). He was treated with anticonvulsives and sodium benzoate, advised a restricted protein diet. What is the reason for the presented symptoms? Why blood urea concentration is reduced? For the answer: a) specify the compound 90% of body nitrogen is excreted in; b) write down the process damaged in this patient: c) point out the enzyme deficient in this clinical case; d) explain the mcchanisms of ammonia toxieitty; c) explain the expedicney of preseribed diet and sodium benzoate.
3. A 15-year-old boy presented with a history of episodic vomiting associated with subacute encephalopathy from the age of one year. There were 2-3 months of asymptomatic periods betwcen the episodes. He was born of non- consanguincous parents at full term had a normal perinatal period with no evidence of birth asphyxia. During the hospitalstay he had 2 episodesofconvulsive seizures. Investigations revealed high blood ammonia (288 ug/dL, normal level is 40-80 ug/dL), markedly elevated levels of citrulline (2200 umoles/L. normal is 1–55 umoles/L), and low blood urea (5 mg/dL, normal is around 7 to 20 mg/dL). He was treated with anticonvulsives and sodium benzoate, advised a restricted protein diet. What is the reason for the presented symptoms? Why blood urea concentration is reduced? For the answer: a) specify the compound 90% of body nitrogen is excreted in; b) write down the process damaged in this patient: c) point out the enzyme deficient in this clinical case; d) explain the mcchanisms of ammonia toxieitty; c) explain the expedicney of preseribed diet and sodium benzoate.
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
Problem 1SRQ
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Transcribed Image Text:3. A 15-year-old boy presented with a history of episodic vomiting associated
with subacute encephalopathy from the age of one ycar. There were 2-3 months
of asymptomatic periods betwcen the episodes. He was born of non-
consanguincous parents at full term had a normal perinatal period with no
evidence ofbirth asphyxia. During the hospital stay he had 2 episodesofconvulsive
seizures. Investigations revealed high blood ammonia (288 ug/dL, normal
level is 40-80 ug/dL), markedly clevated levels of citrulline (2200 umoles/L.
normal is 1-55 umolcs/L), and low blood urea (5 mg/dL, normal is around 7 to
20 mg/dL). He was treated with anticonvulsives and sodium benzoate, advised
a restricted protein diet. What is the reason for the presented symptoms? Why
blood urea concentration is reduced? For the answer:
a) specify the compound 90% of body nitrogen is excreted in;
b) write down the process damaged in this patient:
c) point out the enzyme deficient in this clinical case;
d) cxplain the mcchanisms of ammonia toxicity;
e) explain the expedicncy of preseribed diet and sodium benzoate.
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