PBL Sessions: Vascular Diseases 1


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Page 7

Laboratory Findings (Doris):

Serum chemistries: sodium 146 mmol/L, potassium 4.5 mmol/L, chloride 112 mmol/L, CO2 25 mmol/L, creatinine 1.2 mg/dL, glucose 144 mg/dL.

Urinalysis: sp gr 1.018, pH 6.0, no blood, ketones, glucose, or protein.

CBC: Hgb 12.8 g/dL, Hct 38.2%, MCV 79 fL, platelet count 262,000/microliter, WBC count 7720/microliter.

Prothrombin time 13 seconds with INR 1.0; partial thromboplastin time 30 seconds.

Troponin I is 6 ng/mL, total creatine kinase 180 mg/dL, creatine kinase-MB fraction <1%.


Radiologic Findings (Doris):

Chest CT scan shows areas of diminished attenuation in right and left main pulmonary arteries.


Laboratory Findings (Vickie):

Serum chemistries: sodium 159 mmol/L, potassium 5.1 mmol/L, chloride 110 mmol/L, CO2 9 mmol/L, creatinine 0.8 mg/dL, glucose 439 mg/dL.

Urinalysis: sp gr 1.022, pH 6.5, no blood, 4+ ketones, 4+ glucose.

CBC: Hgb 15.8 g/dL, Hct 48%, MCV 91 fL, platelet count 303,000/microliter, WBC count 8630/microliter.

Tasks

  • What diagnoses are suggested by the laboratory and radiologic findings for these family members?

  • What hypotheses can you suggest that might be causing their problems?

  • Explain your reasoning for the hypotheses you choose.

  • Can you explain the pathophysiology of the disease processes in these patients?

  • What therapy, if any, needs to be given?

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