Mike L., a 47-year-old man, went to his physician for an annualphysical that had been postponed for
Question:
Mike L., a 47-year-old man, went to his physician for an annualphysical that had been postponed for over 3 years. He had startedhis own business 4 years ago and had been extremely busy getting itestablished. Mike’s medical history indicated he was a nonsmoker,and his father and grandfather had histories of myocardialinfarctions before age 55. Since she had not seen this patient in anumber of years, the physician decided to order routine screeningtests.
CHEMISTRY RESULTS:
Test | Patient Results | Reference Range |
Sodium | 143 | 136-145 mEq/L |
Potassium | 4.6 | 3.6-5.0 mEq/L |
Chloride | 104 | 101-111 mEq/L |
CO2 | 29.0 | 24.0-34.0 mEq/L |
Glucose | 95 | 80-120 mg/dL |
BUN | 19 | 7-24 mg/dL |
Creatinine | 1.0 | 0.5-1.2 mg/dL |
Bilirubin Total | 0.5 | 0.2-1.2 mg/dL |
AST | 35 | 5-40 IU/L |
ALP | 70 | 30-157 IU/L |
Total Protein | 7.5 | 6.0-8.4 g/dL |
Albumin | 4.6 | 3.5-5.0 g/dL |
Calcuim | 8.5 | 8.5-10.5 mg/dL |
Cholesterol | 305 | <200 mg/dL |
URINALYSIS:
Macroscopic | Patient Results | Reference Range |
Color | Yellow | Colorless to amber |
Appearance | Clear | Clear |
Specific Gravity | 1.014 | 1.001-1.035 |
pH | 6.0 | 5-7 |
Protein | Neg | Neg |
Glucose | Neg | Neg |
Ketones | Neg | Neg |
Bilirubin | Neg | Neg |
Blood | Neg | Neg |
Urobilinogen | Normal | Normal |
Macroscopic |
|
|
Nitrite | Neg | Neg |
Leukocyte esterase | Neg | Neg |
1. Indicate the abnormal results
2. Which conditions listed for question 2 can the physician ruleout with Mike’s medical history, physical examination, and currentlaboratory results?
3. What is the most probable cause of the abnormal result inthis patient.