Question

Mike L., a 47-year-old man, went to his physician for an annual physical that had been postponed for over 3 years. He had started his own business 4 years ago and had been extremely busy getting it established. Mike’s medical history indicated he was a nonsmoker, and his father and grandfather had histories of myocardial infarctions before age 55. Since she had not seen this patient in a number of years, the physician decided to order routine screening tests.

CHEMISTRY RESULTS:

Test	Patient Results	Reference Range
Sodium	143	136-145 mEq/L
Potassium	4.6	3.6-5.0 mEq/L
Chloride	104	101-111 mEq/L
CO2	29.0	24.0-34.0 mEq/L
Glucose	95	80-120 mg/dL
BUN	19	7-24 mg/dL
Creatinine	1.0	0.5-1.2 mg/dL
Bilirubin Total	0.5	0.2-1.2 mg/dL
AST	35	5-40 IU/L
ALP	70	30-157 IU/L
Total Protein	7.5	6.0-8.4 g/dL
Albumin	4.6	3.5-5.0 g/dL
Calcuim	8.5	8.5-10.5 mg/dL
Cholesterol	305	<200 mg/dL

URINALYSIS:

Macroscopic	Patient Results	Reference Range
Color	Yellow	Colorless to amber
Appearance	Clear	Clear
Specific Gravity	1.014	1.001-1.035
pH	6.0	5-7
Protein	Neg	Neg
Glucose	Neg	Neg
Ketones	Neg	Neg
Bilirubin	Neg	Neg
Blood	Neg	Neg
Urobilinogen	Normal	Normal
Macroscopic
Nitrite	Neg	Neg
Leukocyte esterase	Neg	Neg

1. Indicate the abnormal results

2. Which conditions listed for question 2 can the physician rule out with Mike’s medical history, physical examination, and current laboratory results?

3. What is the most probable cause of the abnormal result in this patient.

Answer 1

1-Abnormal results are cholesterol being 305 mg/dL on the higher side.

2-If asked your medic whether heart illness lurks inaudibly inside you, probabilities are your medic will have no awareness. Besides repeatedly, an effort will be made to forecast your prospect by assessing normal cholesterol examinations.

-As a consequence, your jeopardy, like Marc’s, may be extremely miscalculated. There is marvelous overlay in LDL morals among people intended to have a heart attack and those who will not ever have one.

-Excluding at the extremes, who will grieve a heart attack and who will not, just by observing at cholesterol values. Cholesterol can be a valuable instrument in risk valuation.

-Numerous large trainings have established that cholesterol levels are connected statistically to the danger of heart illness. The advanced cholesterol levels (total and LDL), the superior the probability of heart disease.

3-The Manifold Risk Factor Intercession Trial, or MR FIT, presented that the probability of heart attack in the individuals with cholesterol levels in the maximum 20% was three times that of individuals whose intensities were in the lowermost 20%. The well-known Framingham probationary also exemplified this spectacle.