MEDICAL TECHNOLOGY INTERNSHIP PROGRAM –CHEMISTRY

ANSWER SHEET (TOPIC 7 – CLINICAL ENZYMOLOGY and ELECTROLYTES)

NAME: _____________________________________________________ SCORE: ______________________

COURSE AND YEAR: _________________________________________ DATE: _______________________

INTERN ASSESSMENT ACTIVITY:

CASE ANALYSIS

1. A 36-year-old woman presents to the emergency department with intense upper abdominal pain radiating to
her back, weakness, loss of appetite and severe indigestion after eating. She had not traveled in recent
months. She has not been well for several days.
1.1.What laboratory tests should be ordered to help diagnose this patient?
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1.2.What enzyme tests will be useful in diagnosing this patient?
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1.3.What two diagnoses are most likely for this patient?
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2. A 70-year old woman came to her surgeon with visible jaundice, which had darkened noticeably. She had
no pain but had noticed some weight loss and that her stools were pale. She was a moderate alcoholic and
was not on any drug therapy. Her laboratory findings were:
Bilirubin = 250 umol/L
Alkaline phosphatase = 850 U/L
AST = 87 U/L
ALT = 92 U/L

2.1.What other related laboratory diagnosis would best support the clinical course of the disease?
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2.2.How would you assess the laboratory findings?

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2.3.What would the physician’s diagnosis be different if the patient did not have visible jaundice?
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3. A 32-year-old woman was admitted to the hospital following 2 ½ days of severe vomiting. Before this
episode, she was reportedly well. Physical findings revealed decreased skin turgor and dry mucuous
membranes. Admission study results were as follows:
Serum:
Sodium: 129 mmol/L
K: 5.0 mmol/L
Cl: 77 mmol/L
Osmolality: 265 mOsm/kg
Urine:
Sodium: 8mmol/d
Ketones: trace

3.1.What is the cause for each abnormal plasma electrolyte result?

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3.2.What is the significance of urine sodium and serum osmolality results?
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