Hi, hope your doing well!I was given a case, and this case was divided into parts. I am in the last part, but I was not sure what to do here. I would appreciate it if you help me answer the question.I will leave part one of the case if you needed more info. thank you. PartI- The Investigative ProcessJamie is a 26-year-old graduate student at the University of Arkansas-Monticello. She is working on her PhD inbiology. As a biologist, she enjoys spending time outdoors when she can. The campus is on the edge of the woods andit is a nice place for Jamie to walk and relax to relieve the stress of graduate school. Jamie has not been able to enjoyher walks lately due to the fatigue she has been experiencing. Others have noticed that she does not have the staminashe had in the past to complete her research.Her major professor convinces her that it would be a good idea to make an appointment to see her family physicianto determine the source of her fatigue. He suggests that maybe she has a viral infection, and she just needs to get somerest. She is able to get an appointment with her family practitioner. When she arrives at the clinic, the nurse takes herblood pressure and temperature. Her blood pressure is 128/74 and her temperature is a slightly elevated 101.2°F.She is asked to provide her family medical history and to describe any symptoms she has noticed. Jamie tells herdoctor that her maternal grandmother had rheumatism and was not able to get around. Her father had prostate cancer.She cannot think of any other family illnesses. She tells her doctor that in addition to feeling run down, her kneesand elbows have been aching, and she has been having trouble pipetting because of pain in her hands. She has beenexperiencing frequent cold sores that she has been treating with over-the-counter medication. She attributes her recentweight loss to poor eating habits as a student. On general examination, the doctor finds a rash on her upper backwhere she is typically exposed to the sun and swollen lymph nodes on her neck.The doctor decides that further tests are required to rule out some obvious possibilities. He suspects an autoimmunedisease such as lupus (systemic lupus erythematous, SLE) or rheumatoid arthritis (RA), a tick born disease like Lymedisease, anemia, or chronic Epstein Barr virus syndrome. Jamie is sent to the lab where blood is drawn. She is asked toreturn the following week to review the lab test results. Part IV – Late Stage ComplicationsAfter Jamie's visit with the rheumatologist, she was treated with high levels of prednisone after NSAIDS (non-steroidalanti-inflammatory drug) and anti-malarials were not effective. After graduation, Jamie married another doctoralstudent. Soon after she was married, Jamie became pregnant, but sadly, the pregnancy ended in miscarriage. Jamie wastold by her physician that sometimes patients with lupus produce antibodies that make pregnancy high risk. Jamie andher husband decided to adopt to avoid the pain of another miscarriage.Ten years have passed since her initial diagnosis and Jamie has continued to suffer frequent lupus flares. As a result oflong-term drug usage, she has developed steroid-induced diabetes, hypertension, and osteoporosis. Over the past twoweeks, Jamie has not been feeling well. Her symptoms are different from her usual lupus flares. She is experiencingfatigue, chest pain, and shortness of breath with minor activity. Jamie decides she needs to start exercising andbegins running on the treadmill and collapses. She regains consciousness and is rushed to the emergency room. Shedescribes to the physician that she is having chest pain, and the physician evaluates her for a cardiac event. An ECG(electrocardiogram) is performed and shows abnormal results. The laboratory testing includes myoglobin, cardiactroponin I, and CK-MB. The results are as follows:Cardiac IndicatorsJamie's ResultsReference Values15.8 ng/ml8.5 pg/L153.7 ng/mlTroponin I0-1.5 ng/mL< 5 pg/L0-85 ng/mlСК-МBMyoglobinQuestions1. What is myoglobin?2. What are the three types of troponin found in cardiac muscle?3. What are the three isoenzymes of creatine kinase? Which one is found predominately in heart muscle?4. What does an elevated myoglobin, cardiac troponin I, and CK-MB (creatine kinase isoenzyme) in the bloodindicate to the physician?5. What is Jamie's long-term prognosis?

Cardiac indicators or cardiac enzymes or cardiac biomarkers are myoglobin, troponin, creatine…

Part IV – Late Stage Complications After Jamie's visit with the rheumatologist, she was treated with high levels of prednisone after NSAIDS (non-steroidal anti-inflammatory drug) and anti-malarials were not effective. After graduation, Jamie married another doctoral student. Soon after she was married, Jamie became pregnant, but sadly, the pregnancy ended in miscarriage. Jamie was told by her physician that sometimes patients with lupus produce antibodies that make pregnancy high risk. Jamie and her husband decided to adopt to avoid the pain of another miscarriage. Ten years have passed since her initial diagnosis and Jamie has continued to suffer frequent lupus flares. As a result of long-term drug usage, she has developed steroid-induced diabetes, hypertension, and osteoporosis. Over the past two weeks, Jamie has not been feeling well. Her symptoms are different from her usual lupus flares. She is experiencing fatigue, chest pain, and shortness of breath with minor activity. Jamie decides she needs to start exercising and begins running on the treadmill and collapses. She regains consciousness and is rushed to the emergency room. She describes to the physician that she is having chest pain, and the physician evaluates her for a cardiac event. An ECG (electrocardiogram) is performed and shows abnormal results. The laboratory testing includes myoglobin, cardiac troponin I, and CK-MB. The results are as follows: Jamie's Results 15.8 ng/ml 8.5 ug/L. 153.7 ng/ml Cardiac Indicators Reference Values Troponin I CK-MB Myoglobin 0-1.5 ng/mL < 5 µg/L. 0-85 ng/ml Questions 1. What is myoglobin? 2. What are the three types of troponin found in cardiac muscle? 3. What are the three isoenzymes of creatine kinase? Which one is found predominately in heart muscle? 4. What does an elevated myoglobin, cardiac troponin I, and CK-MB (creatine kinase isoenzyme) in the blood indicate to the physician? 5. What is Jamie's long-term prognosis?

9th Edition

ISBN:9781319114671

Author:Lubert Stryer, Jeremy M. Berg, John L. Tymoczko, Gregory J. Gatto Jr.

Publisher:Lubert Stryer, Jeremy M. Berg, John L. Tymoczko, Gregory J. Gatto Jr.

Chapter1: Biochemistry: An Evolving Science

Section: Chapter Questions

Problem 1P