pjp9494
Badges: 3
Rep:
?
#1
Report Thread starter 2 years ago
#1
A 28-year-old male consulted his general practitioner complaining of fatigue and low energy. On questioning, the patient admitted to similar symptoms over a period of several years. The patient had attributed the fatigue to his job. The patient worked a mix of day and night shifts and assumed his symptoms were caused by his altered sleep pattern. There was no significant past medical history; no recent travel; no history of drug or alcohol abuse. The following test results were obtained from a panel screen:

Total and differential white cell count was normal.

Patient Value
Normal Range
Hb
17.1 g/L
(11.5-18)
Na+
137 mmol/L
(135-145)
K+
3.6 mmol/L
(3.4-4.9)
Urea
6.0 mmol/L
(2.5-8.0)
Creatinine
78 μmol/L
(40-130)
Bilirubin
14 μmol/L
(3-23)
ALT
175 U/L
(3-55)
Alk Phos
70 U/L
(30-130)
TSH
2.3 mU/L
(0.4-4.0)
fT4
16 pmol/L
(9-22)
Iron
36 μmol/L
(5-32)
Transferrin
1.5 g/L
(2.1-4)
Ferritin
67 μg/L
(30-240)
Transferrin Saturation
96 %
(20-55)


1. Describe the biochemical abnormalities and suggest possible diagnoses.
2. How can the diagnosis be confirmed?
3. If left untreated, what is the usual course of the disease?

Case Study 2:

A 21-year-old female was brought to the emergency room with complaints of severe abdominal pain and vomiting. Her clinical history revealed that this was her third admission in the last 18 months, with similar symptoms, but no diagnosis had been made. Previous routine blood tests and abdominal ultrasound had been normal and her symptoms had settled with pain relief and supportive management. On examination, there was diffuse abdominal tenderness but no rigidity; systemic examination was unremarkable. Blood was collected for routine tests, as well as urine for dipstick testing. The nurse doing the dipstick testing noticed that it was very dark colored and was surprised when it turned out to be negative for protein, blood, nitrites and bilirubin. The following test results were obtained from a panel screen:

Total and differential white cell count were normal.

Patient Value
Normal Range
Na+
131 mmol/L
(135-145)
K+
4.2 mmol/L
(3.4-4.9)
Urea
3.8 mmol/L
(2.5-8.0)
Creatinine
89 μmol/L
(40-130)
Adj Calcium
2.35 mmol/L
(2.20-2.60)
Phosphate
0.9 mmol/L
(0.7-1.4)
Albumin
40 g/L
(35-50)
ALT
33 U/L
(3-55)
Alk Phos
77 U/L
(30-130)
Bilirubin
8 μmol/L
(3-23)
Amylase
68 U/L
(0-100)
HCG
<3 U/L
(<3)

1. Describe the biochemical abnormalities and suggest possible diagnoses?
2. How can the diagnosis be confirmed?

All help would be appretaited !!
0
reply
mohammed karim
Badges: 3
Rep:
?
#2
Report 2 years ago
#2
no help
0
reply
X

Quick Reply

Attached files
Write a reply...
Reply
new posts
Back
to top
Latest
My Feed

See more of what you like on
The Student Room

You can personalise what you see on TSR. Tell us a little about yourself to get started.

Personalise

Poll: What factors affect your mental health most right now? Post-lockdown edition

Anxiousness about restrictions easing (24)
6.02%
Uncertainty around my education (45)
11.28%
Uncertainty around my future career prospects (46)
11.53%
Lack of purpose or motivation (52)
13.03%
Lack of support system (eg. teachers, counsellors, delays in care) (20)
5.01%
Impact lockdown had on physical health (18)
4.51%
Social worries (incl. loneliness/making friends) (41)
10.28%
Financial worries (27)
6.77%
Concern about myself or my loves ones getting/having been ill (17)
4.26%
Exposure to negative news/social media (26)
6.52%
Difficulty accessing real life entertainment (11)
2.76%
Lack of confidence in making big life decisions (40)
10.03%
Worry about missed opportunities during the pandemic (32)
8.02%

Watched Threads

View All