HEMATOLOGY & BLOOD CHEMISRY CASE STUDY LAB BIO 132. Dr. Harendza. A bit of “application and analysis” in this assignment. For each set of lab results provide a Dx / diagnosis and Rx / treatment and...






HEMATOLOGY & BLOOD CHEMISRY CASE STUDY LAB



BIO 132. Dr. Harendza.



A bit of “application and analysis” in this assignment. For each set of lab results provide a Dx / diagnosis and Rx / treatment and make a brief statement about why. For some, the Rx may be tricky and you may have to look it up.


Do your own work, unless I tell you otherwise. Be neat and keep column blocks on the page they are now.


Normal values are below. Note that normal values vary slightly from different sources. Some relevant chemistry values for blood are also provided. A more detailed list can be found in Appendix A28 of Marieb. If you don’t know a term, look it up as a couple of the topics are coming up, although almost I have hinted at / mentioned most of them






TABLE OF NORMAL VALUES


































































































parameter




male




Female




Differential




%



RBC (X 106
ocells/mm3)



4.6 - 6.2



4.2 - 5.4



Neutrophils / Neu



60-70



Hematocrit(Hct)



40-52%



37-47%



Lymphocytes / Lymph



25-30



Hemoglobin (Hb)



13-18 G/dl



12-16 G/dl



Monocyte / Mono



2-8



Platelets (# cells/mm3)



150,000 - 350,000



Same



Eosinophils / Eos



1-4



WBC (# cells/mm3)



4,000 - 11,000



Same



Basophils / Baso





Prothombin Time / PT (sec)



11-12.5



Same









Iron (mg/dl)



55-160



40-155









Bilirubin (mg/dl)



0.3-1



Same









Glucose routine (mg/dl)



70-120



Same









Glucose – 12 hr Fast



70-99



Same









Hemoglobin A1-C (%)





Same









Urea / BUN (mg/dl)



7-26



Same















































































































Patient / Symptoms




Lab Results




Dx with Explanation




Rx with Eplanation





Patient 1:




52 year old male


BP = 160/95


Headaches


Heart palpitations





RBC = 8.2


Hct= 59%


Hb = 21


Platelets = 175,000


WBC = 9,500


Diff: normal


PT = 12


Iron = 155


Bilirubin = 0.9


Fasting Glucose = 85


Hb A1-C = 1.5


Urea = 9







Lab result show an elevetated RBCC, hematocrit and hemoglobin. We can also see an elevetated % of hemoglobin A1-C this could indicate that our patient suffers from diabetis mellitus. Although his glucose level seem to be within normal range, his A1-C indicates that his glucoses has been high prior to the test. The patient also has high blood presrure, due to the increased levels of glucose blood viscosity increases as well and it harder for the heart to pump it through the body wich is why his blood preasue is increased.



We can recommend a change in lifestyle to lower his A1-C. Increasing physical activity and a diet change.




Patient / Symptoms




Lab Results




Dx




Rx





Patient 2:




24 year old male


Motor cycle accident


Unconscious


BP 80/30


Pulse 120





RBC = 3.1


Hct= 32


Hb = 7.2


Platelets = 300,000


WBC = 7,000


Diff= Normal


PT = 13


Iron = 150


Bilirubin = 0.6


Glucose = 85


Hb A1-C = 3


Urea = 9



Lab results show a low RBC count, as well as a low hematocrit and hemoglobin. She also has a low blood pressure and a pulse of 120. He was in a motorcycle accident. I believe he has hemorrhage anemia due to rapid blood loss from an injury. When the body looses blood quickly pulls water from tissue outside the blood stream, this dilutes blood and causes the hematocrit to be reduce. As a result of blood loss, blood flow isreuce to vital organs, this causes a week pulse and low blood pressure as well as dizines or unconciousnes.



To treat this we need to stop the hemorrage. We can do a redblood cell transfusion and maybe iron supplement to increase the RBC production.





Patient 3




27 year old female


Low grade fever


Extreme fatigue


Aches & pains


Upset stomach

















RBC = 5.1


Hct= 43


Hb = 13.5


Platelets = 280,000


WBC = 17,500


Diff= 45% N, 25%, L, 26% M, 3% E, 1% B


PT = 12


Iron = 150


Bilirubin = 0.6


Glucose = 90


Hb A1-C = 0.5


Urea = 21





This patients lab result seem for the most part normal, with the exeption of an increased % level of monocytes. Along with her symptoms I believe this patient might have a viral infction.



Since this is a viral infection there is not much we can prescribe the patient. We can recommend tyleno to reduce the five and help with the aches and pains.





Patient 4




57 year male


Lethargy


Headaches


Pallor


Poor diet


Chronic upset stomach





RBC = 4.0


Hct= 36


Hb = 11.5


Platelets = 290,000


WBC = 4,500


Diff: normal but



RBCs enlarged


PT = 13


Iron = 135


Bilirubin = 0.4


Fasting Glucose = 81


Hb A1-C = 2.5


Urea = 13











Patient 5




37 year old female


Ovarian CA patient Undergoing chemotherapy Receiving Procrit / EPO















RBC = 4.2


Hct= 37


Hb = 13.5


Platelets = 150,000


WBC = 2,000


Diff =


10% Neu


65%, Lymp


25% Mono


8 % E


2% B


PT = 14.5


Iron = 110


Bilirubin = 0.6


Fasting Glucose = 95


Hb A1-C = 2


Urea = 18












Patient / Symptoms




Lab Results




Dx




Rx





Patient 6




47 year old female


Has developed rheumatoid arthritis, Sjorgens syndrome & Lupus


Lethargiy


Pallor


Upon blood draw, plasma shows a reddish hue







RBC = 3.8


Hct= 33


Hb = 11


Platelets = 235,000


WBC = 10,200


Diff = normal


PT = 13


Iron = 70


Bilirubin = 2.1


Fasting Glucose = 90


Hb A1-C = 3


Urea = 7















Patient 7




42 year old male


Obese


BP 125 / 90


Polyuria


Frequenc thirst


Symptoms recently became more noticable





RBC = 5.2


Hct= 45


Hb = 15.5


Platelets = 290,000


WBC = 8,000


Diff = normal


PT = 13


Iron = 160


Bilirubin = 0.4


Fasting glucose = 135


Hb A1-C = 9


Urea = 19















Patient 8




68 year old male


Fatigue


Hematuria


Proteinuria


Polyuria


Chronic hypertension





RBC = 4.5


Hct= 39


Hb = 11.5


Platelets = 240,000


WBC = 8,000


Diff: normal


PT = 13


Iron = 67


Bilirubin = 0.4


Fasting Glucose = 81


Hb A1-C = 2.5


Urea = 41















Patient 9




63 year old male


Lung CA patient Undergoing chemotherapy Receiving Procrit / EPO







RBC = 4.6


Hct= 44


Hb = 14.5


Platelets = 50,000


WBC = 8,000


Diff = normal


PT = 13


Iron = 160


Bilirubin = 0.7


Fasting glucose = 95


Hb A1-C = 3


Urea = 19
















Patient / Symptoms




Lab Results




Dx




Rx





Patient 10




29 year old male


Losing weight


Occasional diarrhea


Just returned from South America











RBC = 5.4


Hct= 42


Hb = 14


Platelets = 300,000


WBC = 18,500


Diff =


53% Neu


20%, L,ym


10% Mono


15% Eos


1% Baso


PT = 20


Iron = 160


Bilirubin = 0.6


Fasting glucose = 90


Hb A1-C = 2


Urea = 3













Patient 11




44 year old female


Fatigue


Pallor


Heavy and prolong periods











RBC = 3.5


Hct= 33


Hb = 9.5


Platelets = 300,000


WBC = 7,000


Diff= Normal – RBCs are pale and small


PT = 13


Iron = 35


Bilirubin = 0.6


Glucose = 85


Hb A1-C = 3


Urea = 9













Patient 12




52 year old female


Occaional pain ain in the right scapula


Trip to ED promted by inense scapular pain and GI upset after eating 18 chicken wings and an ice cream cone


Icteric sclera





RBC = 4.7


Hct= 41


Hb = 13.5


Platelets = 325,000


WBC = 10,500


Diff= Normal


PT = 16


Iron = 65


Bilirubin = 7


Glucose = 85


Hb A1-C = 3


Urea = 22











Mar 08, 2021
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