PBL Sessions: Reproductive Organ System


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Page 3

History of Present Illness:

An arterial blood gas analysis shows: pO2 102 mm Hg, pCO2 35 mm Hg, pH 7.44, HCO3 22 meq/L.

A CBC shows WBC count 7750/microliter with differential count of 66 segs, 3 bands, 23 lymphs, 7 monos, and 1 eosinophil, Hgb 13.3 g/dL, Hct 40.1%, MCV 87 fL, and platelet count 199,000/microliter. Serum chemistries show sodium 144 mmol/L, potassium 4.5 mmol/L, chloride 105 mmol/L, CO2 23 mmol/L, creatinine 1.1 mg/dL, and glucose 78 mg/dL.

An EKG shows sinus tachycardia, an S wave in lead I, a Q wave in lead III, and an inverted T wave in lead III.

The quantitative plasma D-dimer enzyme-linked immunosorbent assay (ELISA) level is elevated (>500 ng/mL)

Figure 1: V/Q Scan

Tasks

  • What do these findings indicate?

  • What hypotheses explain these findings?

  • Explain your reasoning for the hypotheses you choose.

  • What learning issues are being identified?

  • What additional information might you request?

Stop !! Complete discussions and tasks before moving to the next page.