Question

A 60-year-old woman came to her physician because she was having problems with urination. Her previous history included hypertension and episodes of edema. The physician ordered various laboratory tests on blood drawn in his office. The results are shown in Case Study Table 14-4.1. Questions 1. What are the abnormal results in this case? 2. Why do you think the triglycerides are abnormal? 3. What is the primary disease exhibited by this patient’s laboratory data?

CASE STUDY TABLE 14-4.1 LABORATORY RESULTS PATIENT REFERENCE ANALYTE VALUES RANGE Na 149 135–143 mEq/L K 4.5 3.0–5.0 mEq/L Cl 120 98–103 mEq/L CO2 content 12 22–27 mmol/L Total protein 5.7 6.5–8.0 g/dL Albumin 2.3 3.5–5.0 g/dL Ca2 7.6 9.0–10.5 mg/dL Cholesterol 201 140–200 mg/dL Uric acid 15.4 3.5–7.9 mg/dL Creatinine 4.5 0.5–1.2 mg/dL BUN 87 7–25 mg/dL Glucose 88 75–105 mg/dL Total bilirubin 1.3 0.2–1.0 mg/dL Triglycerides 327 65–157 mg/dL Lactate 200 90–190 IU/L dehydrogenase Aspartate 45 8–40 IU/L transaminase Amylase 380 76–375 IU/L

Answer 1

Answer 1. According to the data given

Sodium, chloride, Carbon dioxide, total protein, albumin, calcium, Uric acid, creatinine BUN , Total bilirubin, triglycerides, lactate, aspartate, amylase levels are abnormal.

explanation:

sodium levels in blood should be in 135-143mEq/l

uric acid should be in range of 3.5-7.9mg/dl

albumin level should be in 2.5-5.0gm/dl as patient past shows having edema.

creatinine should be in 0.5-1.2mg/dl

urea should be in range of 7-25mg/dl

total bilirubin should be in 0.2-1.0mg/dl

triglyceride should be in 65-157mg/dl

calcium low due to osteoporosis (age-60)

Answer 2-

Triglyceride is high in this condition, because in chronic kidney disease associated with dyslipidemia comprising high triglyceride value 327mg/dl. normal(65-157mg/dl) or may patient suffering from heart diseases as patient age is around 60 years High density lipoprotein level is low, lactate dehydrogenase is high also.

Answer 3- Chronic kidney disease, nephrotic syndrome, glomerulonephritis is being suspected initially because increased value of creatinine, urea, uric acid, chloride triglycerides, low level of total protein especially- albumin, Recent studies show also that mildly elevated bilirubin associated in kidney damage or dysfunction.