A 3-year-old girl was admitted with a diagnosis of acute lymphocytic leukemia. After admission, she was treated by administration of packed red cells, 2 units of platelets, IV fluids, and allopurinol. On the second hospital day, chemotherapy was begun, using IV vincristine and prednisone and intrathecal injections of methotrexate, prednisone, and cytosine arabinoside. She was discharged for home care 5 days later. She was continued on prednisone and allopurinol at home. She received additional chemotherapy 1 month later (11/1) and again on 11/14. On 12/6, she was readmitted because she had painful sores in her mouth and was unable to eat. LABORATORY RESULTS 10/1 10/2 10/3 10/4 11/14 12/6 6/20 Urea N 12.0 4.0 ** ** 15 ** 2.0 (mg/dL) Creatinine 0.7 (mg/dL) 0.7 ** ** ** 1.0 0.7 Uric acid (mg/dL) 12.0 9.2 4.0 1.9 2.3 ** 3.1 WBC 56,300 3,700 ** ** 2,800 3,700 ** (mm³) **indicates test not performed Questions: 1. How would you explain the significant elevations of uric acid on admission? 2. Which two factors are responsible for the normal concentrations of uric acid seen in subsequent admissions? 3. Which is the most likely cause of the abnormally low concentration of urea nitrogen observed on 12/6? Which other laboratory test would confirm your suspicions?
A 3-year-old girl was admitted with a diagnosis of acute lymphocytic leukemia. After admission, she was treated by administration of packed red cells, 2 units of platelets, IV fluids, and allopurinol. On the second hospital day, chemotherapy was begun, using IV vincristine and prednisone and intrathecal injections of methotrexate, prednisone, and cytosine arabinoside. She was discharged for home care 5 days later. She was continued on prednisone and allopurinol at home. She received additional chemotherapy 1 month later (11/1) and again on 11/14. On 12/6, she was readmitted because she had painful sores in her mouth and was unable to eat. LABORATORY RESULTS 10/1 10/2 10/3 10/4 11/14 12/6 6/20 Urea N 12.0 4.0 ** ** 15 ** 2.0 (mg/dL) Creatinine 0.7 (mg/dL) 0.7 ** ** ** 1.0 0.7 Uric acid (mg/dL) 12.0 9.2 4.0 1.9 2.3 ** 3.1 WBC 56,300 3,700 ** ** 2,800 3,700 ** (mm³) **indicates test not performed Questions: 1. How would you explain the significant elevations of uric acid on admission? 2. Which two factors are responsible for the normal concentrations of uric acid seen in subsequent admissions? 3. Which is the most likely cause of the abnormally low concentration of urea nitrogen observed on 12/6? Which other laboratory test would confirm your suspicions?
Human Anatomy & Physiology (11th Edition)
11th Edition
ISBN:9780134580999
Author:Elaine N. Marieb, Katja N. Hoehn
Publisher:Elaine N. Marieb, Katja N. Hoehn
Chapter1: The Human Body: An Orientation
Section: Chapter Questions
Problem 1RQ: The correct sequence of levels forming the structural hierarchy is A. (a) organ, organ system,...
Related questions
Question
Transcribed Image Text:A 3-year-old girl was admitted with a diagnosis of acute lymphocytic leukemia. After admission,
she was treated by administration of packed red cells, 2 units of platelets, IV fluids, and allopurinol.
On the second hospital day, chemotherapy was begun, using IV vincristine and prednisone and
intrathecal injections of methotrexate, prednisone, and cytosine arabinoside. She was discharged
for home care 5 days later. She was continued on prednisone and allopurinol at home. She
received additional chemotherapy 1 month later (11/1) and again on 11/14. On 12/6, she was
readmitted because she had painful sores in her mouth and was unable to eat.
LABORATORY RESULTS
10/1
10/2
10/3
10/4
11/14
12/6
6/20
Urea N
12.0
4.0
**
**
15
**
2.0
(mg/dL)
Creatinine 0.7
(mg/dL)
0.7
**
**
**
1.0
0.7
Uric acid
(mg/dL)
12.0
9.2
4.0
1.9
2.3
**
3.1
WBC
56,300
3,700
**
**
2,800
3,700
**
(mm³)
**indicates test not performed
Questions:
1. How would you explain the significant elevations of uric acid on admission?
2. Which two factors are responsible for the normal concentrations of uric acid seen in subsequent
admissions?
3. Which is the most likely cause of the abnormally low concentration of urea nitrogen observed on
12/6? Which other laboratory test would confirm your suspicions?
Expert Solution
This question has been solved!
Explore an expertly crafted, step-by-step solution for a thorough understanding of key concepts.
This is a popular solution!
Trending now
This is a popular solution!
Step by step
Solved in 2 steps
Knowledge Booster
Learn more about
Need a deep-dive on the concept behind this application? Look no further. Learn more about this topic, biology and related others by exploring similar questions and additional content below.Recommended textbooks for you
Human Anatomy & Physiology (11th Edition)
Biology
ISBN:
9780134580999
Author:
Elaine N. Marieb, Katja N. Hoehn
Publisher:
PEARSON
Biology 2e
Biology
ISBN:
9781947172517
Author:
Matthew Douglas, Jung Choi, Mary Ann Clark
Publisher:
OpenStax
Anatomy & Physiology
Biology
ISBN:
9781259398629
Author:
McKinley, Michael P., O'loughlin, Valerie Dean, Bidle, Theresa Stouter
Publisher:
Mcgraw Hill Education,
Human Anatomy & Physiology (11th Edition)
Biology
ISBN:
9780134580999
Author:
Elaine N. Marieb, Katja N. Hoehn
Publisher:
PEARSON
Biology 2e
Biology
ISBN:
9781947172517
Author:
Matthew Douglas, Jung Choi, Mary Ann Clark
Publisher:
OpenStax
Anatomy & Physiology
Biology
ISBN:
9781259398629
Author:
McKinley, Michael P., O'loughlin, Valerie Dean, Bidle, Theresa Stouter
Publisher:
Mcgraw Hill Education,
Molecular Biology of the Cell (Sixth Edition)
Biology
ISBN:
9780815344322
Author:
Bruce Alberts, Alexander D. Johnson, Julian Lewis, David Morgan, Martin Raff, Keith Roberts, Peter Walter
Publisher:
W. W. Norton & Company
Laboratory Manual For Human Anatomy & Physiology
Biology
ISBN:
9781260159363
Author:
Martin, Terry R., Prentice-craver, Cynthia
Publisher:
McGraw-Hill Publishing Co.
Inquiry Into Life (16th Edition)
Biology
ISBN:
9781260231700
Author:
Sylvia S. Mader, Michael Windelspecht
Publisher:
McGraw Hill Education