Need help with my case studies..!!

[Mike2005]

Hi all nurses!!

I'm a nursing student and I have three biochemistry cases as a part of my study, but I'm very confused about these case studies and I need ur healp.

Case 1:

A 52 year old women presented with dry eyes and pains in elbows and knees. A variety of investigations were carried out amongst which were urea and electrolytes.

Na:131

Reference Values:135 - 145 mmol/L

K:3.1

Reference Values:3.5 - 5.0 mmol/L

CI:109

Reference Values:96 - 106 mmol/L

CO2: 10

Reference Values:22 - 29 mmol/L

Urea :6.5

Reference Values:3.0 - 7.0 mmol/L

Creatinine: 88

Reference Values:55 - 125 mmol/L

What might be concluded from these results?

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Case 2:

A middle aged man was sent to casualty with acute chest pain. His ECG was equivocal but he was addmitted to a coronary care unit with a presumptive diagnosis of myocardial infarction. The ECG did not alter over the next three days, and serial levels of cardiac enzymes are given below:

CK (Total)

day1: 243

day2: 93

day3: 50 IU/L

Reference Values: 50 - 190 IU/L

CK-MB

day1: 9

day2:4

day3: 2 ng/L

Reference Values: 0.1 - 5.0 ng/L

Troponin-T

day1: 0.1

day2: 0.1

day3: 0.1mg/L

Reference Values: 0 - 0.1 mg/L

Myoglobin

day1: 65

day2: 60

day3: 60 mg/L

Reference Values:

Has he had a myocardial infarction? Explain your answer.

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Case 3:

The LFT results given below were a 77 year old with carcinoma of the colon who had an enlarged non-tender liver but no evidence of jaundice.

Total Protein 64/L

Reference Values (65-80)

ALT 78U/L

Reference Values (

Bilirubin 19mmol/L

Reference Values (

Albumin 35g/L

Reference Values (30-50)

Alk. Phos. 700U/L

Reference Values (30-120)

What do these results indicate?

Can you please help me answer these cases?

Thanks in advance!

[VickyRN, MSN, DNP, RN]

Just some thoughts:

Case Study #1 - You must mean creatinine clearance for the value of 88 instead of creatinine :uhoh21:

Try looking here for some "leads":

http://adam.about.com/encyclopedia/000429.htm

http://adam.about.com/encyclopedia/000481.htm

http://adam.about.com/encyclopedia/000431.htm

http://arthritis.about.com/od/vasculitis/g/vasculitis.htm

http://adam.about.com/encyclopedia/000469.htm

http://www.davita.com/articles/ckd/all_about_ckd/?id=92

Case Study # 2 - Try looking here for some insight into the different cardiac enzyme panels and what they mean:

http://classes.kumc.edu/son/nurs420/unit5/cardiac_enzymes.htm

http://www.emedicine.com/med/topic1567.htm

The big question is - After three days' analysis of cardiac enzyme data, has this patient ruled in (for a MI) or ruled out? Are the enzymes positive or negative for a MI?

Case Study # 3 - Try looking here:

http://jrnlappliedresearch.com/articles/Vol5Iss1/saif.pdf

http://www.gastromd.com/lft.html

http://www.apas.org.uk/the_liver.htm

http://www.labtestsonline.org/understanding/analytes/alp/test.html

http://www.phoenix5.org/glossary/alkaline_phosphatase.html

[Mike2005]

VickyRN, you are a very great person. Because of your help I've got high distinction in this unit.

Thank you very much for your support.

(Sorry for late reply)

[VickyRN, MSN, DNP, RN]

Glad to be of assistance :)