100 Cases for Medical Data Interpretation by David Howlett, Nicola Gainsborough

By David Howlett, Nicola Gainsborough

Part 1: medical chemistry Case 1: aged girl with historical past of vomiting Case 2: An aged guy with shortness of breath Case three: a lady with headache Case four: An aged guy with a cough Case five: a lady with belly soreness Case 6: A depressed aged guy Case 7: with headache and vomiting Case eight: a guy with serious vomiting Case nine: a guy chanced on semi-conscious Case 10: younger lady with aspirin overdose Read more...

summary: part 1: medical chemistry Case 1: aged lady with heritage of vomiting Case 2: An aged guy with shortness of breath Case three: a lady with headache Case four: An aged guy with a cough Case five: a lady with stomach discomfort Case 6: A depressed aged guy Case 7: with headache and vomiting Case eight: a guy with critical vomiting Case nine: a guy came across semi-conscious Case 10: younger lady with aspirin overdose Case eleven: Asthmatic male with cough Case 12: a guy with renal failure Case thirteen: youngster with colicky ache Case 14: guy with diabetes mellitus Case 15: aged guy with dysuria Case sixteen

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5. What are the possible causes of her vomiting and headache? 6. What explanation can you provide for the alkaline phosphatase? indb 35 13/05/13 8:42 PM 36 Section 1: Clinical Chemistry Answers 1. The patient may complain of drowsiness, fever, sweating, headache, ear ache, ­nausea, vomiting and thirst. Her pulse would be rapid due to infection, vomiting and diabetic ketoacidosis (DKA). Her blood pressure (BP) may well be low due to her dehydration, vomiting, poor oral intake and possible underlying sepsis.

6. What explanation can you provide for the alkaline phosphatase? indb 35 13/05/13 8:42 PM 36 Section 1: Clinical Chemistry Answers 1. The patient may complain of drowsiness, fever, sweating, headache, ear ache, ­nausea, vomiting and thirst. Her pulse would be rapid due to infection, vomiting and diabetic ketoacidosis (DKA). Her blood pressure (BP) may well be low due to her dehydration, vomiting, poor oral intake and possible underlying sepsis. Dehydration is likely to be present and is due to her osmotic diuresis secondary to her hyperglycaemia.

Pseudohypoparathyroidism (rare) iv. Parathormone resistance (rare) d. Other causes i. Acute pancreatitis ii. Severe hypomagnesaemia iii. Rapid cell breakdown – tumour lysis syndrome, rhabdomyolysis iv. Hypercalciuric hypocalcaemia – autosomal dominant condition (rare) v. High calcitonin levels (rare) 4. Calprotectin is produced by neutrophils and elevated concentrations in faeces are associated with inflammation in the intestine. Faecal calprotectin is used as a marker for inflammatory bowel disease.

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