PBL Sessions: Vascular Diseases 2

Page 6

History of Present Illness:

Additional laboratory findings on the patient include a total serum cholesterol of 381 mg/dL, LDL cholesterol 277 mg/dL, HDL cholesterol 28 mg/dL, and triglyceride 189 mg/dL. A glucose tolerance test shows a serum glucose of 118 mg/dL at the start of the test, 162 mg/dL at 1 hour, and 131 mg/dL at 2 hours.

Representative sections of the patient's myocardium are shown here:

Figure 5: Microscopic appearance of the myocardium

Figure 6: Microscopic appearance of the myocardium

Figure 7: Microscopic appearance of the myocardium

Tasks

• What do these findings indicate?

• Can you correlate each microscopic image with the history of this patient?

• What hypotheses explain these findings?

• Explain your reasoning for the hypotheses you choose.

• Is there anything that can tie these findings together?

• What additional laboratory test(s) would you order on this patient?

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