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عندي واجب بمادة الكيمياء ومو عارفة احله كله :sm175:
وابغاه ضروري ارجوكم الي يعرف يساعدني وراح ادعيله :sm198:
هوا عباره عن كيسات وشوية اسئله عن تشخيصها ...>>>
هادا الاول:
Case scenario I:
• A 30-year-old man with a 5-year history of diabetes mellitus was brought by ambulance to the Emergency department (ED). He was unconscious but responsive to painful stimuli.
Earlier in that week he had a fever and cough (infection) then he developed nausea, vomiting, abdominal pain, and increasing lethargy until the morning of admission when he could not be aroused by a family member.
• Physical examination revealed:
deep, rapid, sighing respiration and a fruity (aceton) odor breath.
• Laboratory data:
A-blood sample revealed:
Pateint Normal reference range
Sodium 140 mmol/L 136–142
Potassium 5.8 mmol/L 3.5–5.0
Chloride 97 mmol/L 98–108
Urea nitrogen 26 mg/dL 9–25
Creatinine 1.2 mg/dL 0.7–1.3
Glucose 581 mg/dL 70-110
pH: 6.89 7.35–7.45
H+ : 65 mmol/L 35- 45
Bicarbonate: 13 mmol/L 21–28
Measured osmolality: 340mOsmol/kg H2O
B- urine sample revealed:
Glucose: 4 + Negative
Ketones: positive Negative
Albumin 150 mg/24 hour < 25 mg/24 hour
1- What was the name of blood sample ordered for glucose assay?
2- Comment on blood glucose level?
3- What is the type of diabetes in this case?
4- What is the pathogenesis of that type of diabetes?
5- What are the symptoms of diabetes?
6- What is the diagnosis of this emergency case?
7- Explain the underlying pathology of this case?
8- What is the precipitating factor for this case?
9- What is the type of acid-base disturbance in this case?
10- Give the name of that respiratory pattern?
11- What is the stimulus for that respiratory pattern?
12- What is the aim of that respiratory pattern?
13- What test can be done to detect glycemic control of that patient over
the preceding 2 months?
14- Calculate and comment on anion gap?
15- What does this anion gap result indicate?
16- Calculate the plasma osmolality?
17- What is the cause for the difference between measured and calculated
osmolality?
18- Comment on the electrolyte results?
19- What is the etiology for that potassium (K+) level?
20- Why the patient should be given K+ during the treatment?
21- What is the proper action of laboratory staff if K+ level reach 6.7
mmol/l?
22- And why?
23- The presence of ketones, albumin and glucose in urine are known as: ……,……,…………
24- What does the presence of that urinary albumin level indicate?
هادا التاني:
Case scenario II:
A 70 year old obese male, presented to the emergency department with sudden onset of chest pain radiating to left arm. He smokes a 2-pack of cigarettes/day for 20 years.
The serum sample was milky and the cardiac markers were performed at admission and 8 hours post admission with the following results:
Blood sample revealed:
Normal reference range Time of admission 8 hour post admission
CK-MB (0-5ng/L) 5.3 9.2
Myoglobin (<70ug/L) 80 124
Troponin T (0-0.1 ug/L) <0.1 1.3
Cholesterol (<200 mg/dl) 300
LDL-C (60-160 mg/dl) 200
HDL-C (30- 75 mg/dl) 20
T.G (60-160 mg/dl) 400
1- Do these results indicate a specific diagnosis?
2- If so, what is the diagnosis?
3- Which of the cardiac maker results do confirm your diagnosis?
4- Which of the patient's habits/health problem would increase his risk for this condition?
5- Which of the laboratory finding might indicate his risk for further events of this attack?
6- Does the gender have a role in that event?
7- If so, what is most likely protective factor in female before age of menopause?
8- What is the proper time for repeating lipid profile?
9- Why should not repeat lipid profile before that time?
10- Which of preceding cardiac markers would be diagnostic if the patient presented to ED 15 hour after the attack of chest pain?
11- Can any modification be made about the patient's habits/health, life style that would decrease his risk for future event?
12- What is the name of the milky appearance of serum?
13- What is the significance of the milky appearance of serum?
14- Which type of laboratory assays would be affected by that milky sample and why?
15- Does the TG level indicate the risk for non cardiac problem?
16- If so, what would be?
وشكررررررا مقدما :sm199:[/COLOR][/SIZE][/SIZE]
عندي واجب بمادة الكيمياء ومو عارفة احله كله :sm175:
وابغاه ضروري ارجوكم الي يعرف يساعدني وراح ادعيله :sm198:
هوا عباره عن كيسات وشوية اسئله عن تشخيصها ...>>>
هادا الاول:
Case scenario I:
• A 30-year-old man with a 5-year history of diabetes mellitus was brought by ambulance to the Emergency department (ED). He was unconscious but responsive to painful stimuli.
Earlier in that week he had a fever and cough (infection) then he developed nausea, vomiting, abdominal pain, and increasing lethargy until the morning of admission when he could not be aroused by a family member.
• Physical examination revealed:
deep, rapid, sighing respiration and a fruity (aceton) odor breath.
• Laboratory data:
A-blood sample revealed:
Pateint Normal reference range
Sodium 140 mmol/L 136–142
Potassium 5.8 mmol/L 3.5–5.0
Chloride 97 mmol/L 98–108
Urea nitrogen 26 mg/dL 9–25
Creatinine 1.2 mg/dL 0.7–1.3
Glucose 581 mg/dL 70-110
pH: 6.89 7.35–7.45
H+ : 65 mmol/L 35- 45
Bicarbonate: 13 mmol/L 21–28
Measured osmolality: 340mOsmol/kg H2O
B- urine sample revealed:
Glucose: 4 + Negative
Ketones: positive Negative
Albumin 150 mg/24 hour < 25 mg/24 hour
1- What was the name of blood sample ordered for glucose assay?
2- Comment on blood glucose level?
3- What is the type of diabetes in this case?
4- What is the pathogenesis of that type of diabetes?
5- What are the symptoms of diabetes?
6- What is the diagnosis of this emergency case?
7- Explain the underlying pathology of this case?
8- What is the precipitating factor for this case?
9- What is the type of acid-base disturbance in this case?
10- Give the name of that respiratory pattern?
11- What is the stimulus for that respiratory pattern?
12- What is the aim of that respiratory pattern?
13- What test can be done to detect glycemic control of that patient over
the preceding 2 months?
14- Calculate and comment on anion gap?
15- What does this anion gap result indicate?
16- Calculate the plasma osmolality?
17- What is the cause for the difference between measured and calculated
osmolality?
18- Comment on the electrolyte results?
19- What is the etiology for that potassium (K+) level?
20- Why the patient should be given K+ during the treatment?
21- What is the proper action of laboratory staff if K+ level reach 6.7
mmol/l?
22- And why?
23- The presence of ketones, albumin and glucose in urine are known as: ……,……,…………
24- What does the presence of that urinary albumin level indicate?
هادا التاني:
Case scenario II:
A 70 year old obese male, presented to the emergency department with sudden onset of chest pain radiating to left arm. He smokes a 2-pack of cigarettes/day for 20 years.
The serum sample was milky and the cardiac markers were performed at admission and 8 hours post admission with the following results:
Blood sample revealed:
Normal reference range Time of admission 8 hour post admission
CK-MB (0-5ng/L) 5.3 9.2
Myoglobin (<70ug/L) 80 124
Troponin T (0-0.1 ug/L) <0.1 1.3
Cholesterol (<200 mg/dl) 300
LDL-C (60-160 mg/dl) 200
HDL-C (30- 75 mg/dl) 20
T.G (60-160 mg/dl) 400
1- Do these results indicate a specific diagnosis?
2- If so, what is the diagnosis?
3- Which of the cardiac maker results do confirm your diagnosis?
4- Which of the patient's habits/health problem would increase his risk for this condition?
5- Which of the laboratory finding might indicate his risk for further events of this attack?
6- Does the gender have a role in that event?
7- If so, what is most likely protective factor in female before age of menopause?
8- What is the proper time for repeating lipid profile?
9- Why should not repeat lipid profile before that time?
10- Which of preceding cardiac markers would be diagnostic if the patient presented to ED 15 hour after the attack of chest pain?
11- Can any modification be made about the patient's habits/health, life style that would decrease his risk for future event?
12- What is the name of the milky appearance of serum?
13- What is the significance of the milky appearance of serum?
14- Which type of laboratory assays would be affected by that milky sample and why?
15- Does the TG level indicate the risk for non cardiac problem?
16- If so, what would be?
وشكررررررا مقدما :sm199:[/COLOR][/SIZE][/SIZE]
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