Question

Background:

A 25-year-old African-American female complaining of tiredness and increased urination presented with swelling of the legs and feet. Her blood pressure at the time of intake was 185/95, indicating hypertension. Her chart indicates she is 5 feet 2 inches tall and weighs 120 pounds.

Clinical Test Results:

Glucose using glucose meter (blood): 120 mg/dL

Glucose test with Benedict’s reagent (urine): acid green

Glucose test using reagent strips (urine): army green / brown

Protein: cloudy white precipitate forms Specific Gravity: 1.002 pH: 6.0

Ions: none

Urine observation: medium yellow Ketones: no precipitate is present

Urobilinogen: no pink color is detected

CK enzyme				LD enzyme
	Positive Sample	Patient			Positive Sample	Patient
time (min)	absorbance	absorbance		time (min)	absorbance	absorbance
0.5	10	10		0.5	20	20
1	30	20		1	50	50
1.5	60	40		1.5	100	110
2	110	70		2	180	180
2.5	160	100		2.5	260	250
3	210	130		3	340	320
3.5	260	160		3.5	420	390
4	310	190		4	500	460
4.5	360	220		4.5	580	530
5	410	250		5	660	600
5.5	460	280		5.5	740	670
6	510	310		6	820	740
6.5	560	340		6.5	900	810
7	610	370		7	980	880
7.5	660	400		7.5	1060	950
8	710	430		8	1140	1020
8.5	760	460		8.5	1220	1090
9	810	490		9	1300	1160
9.5	860	520		9.5	1380	1230
10	910	550		10	1460	1300
10.5	960	580		10.5	1540	1370
11	1010	610		11	1620	1440
11.5	1060	640		11.5	1700	1510
12	1110	670		12	1780	1580
12.5	1130	700		12.5	1810	1610
13	1150	720		13	1840	1640
13.5	1160	730		13.5	1860	1660
14	1170	740		14	1870	1670
14.5	1180	750		14.5	1880	1680
15	1180	750		15	1880	1680

A. Based on the table, can you determine the CK and LD (needs to be graphed to determine value). What does the table represent?

B.What tests can be done to determine what is wrong with the patient and an explanation as to why each of the tests completed would be valuable to the diagnostic process.

C.Evaluation of the clinical test results provided for the unknown case study with a detailed explanation of interpreted results.

D.Conclusion regarding the potential disease(s) present in the unknown scenario, the final diagnosis supported with specific clinical test results.

E.Potential treatment plan for the unknown case study patient.

Answer 1

Here, A 25 year old African lady, Ck value and LD is increased. Ck, in a healthy adult the serum Ck level varies with number of factors gender, race and activity. But normal range is 22 to 198 U/L units per litre. Higher amount of serum Ck can indicate muscle damage due to chronic disease or acute muscle injury.

CK stands for Creatine kinase, an enzyme that leaked out of damaged muscle. When elevated CK levels are found in blood sample, it usually means muscle is being destroyed by some abnormal process.,such as muscular dystrophy or inflammation.

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Lactate dehydrogenase test looks for signs of damage to the body tissues. LDH is an enzymes found in almost every cell of your body including your blood, muscles, brain, kidneys and pancreas.

The enzymes turn sugar into energy. The LDH test measures the amount of LDH in your blood or other body fluid.

Why we check LDH?

To measure whether, you have tissue damage and, if so, how much.

To monitor severe infections or conditions like hemolytic or megaloblastic anemias, kidney disease and liver disease.

Normal levels of LDH in the blood usually range between 140 units per litre U/L to 280 U/L,for adults and tened to be higher for children and teens.

In cerebrospinal fluid normal levels are 70 U/L or lower for newborns.

40 U/L or lower for adults.

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THE early symptoms of type 2 Diabetic mellitus include thirst, tiredness and frequent urination.

Weight is normal, 120 pounds in kg=54.4kg.

Swelling of the legs and feet occur because when the blood pressure starts to raise, the fluid is pushed in the alveoli, reducing the normal oxygen movement.