Lab Quiz - Case Studies

Question 1

The man with the yellow eyes - Signs and Symptoms:

Answer 1

• Severe abdominal & right shoulder pain
• Headache
• Cough
• Blurred vision
• Yellow eyes

Question 2

The man with the yellow eyes - Vitals:

Answer 2

• 101 degree temperature (high)
• BP: 90/60 (low)
• Respiratory rate: 25 bpm (high)

Question 3

The man with the yellow eyes - Explanation of Signs and Symptoms:

Answer 3

• Jaudice: caused by high level of bilirubin. Bilirubin levels are high because the sickle cells are breaking and leaving a lot of pigment behind.
• Abnormal genetic mutation causes the sickle-shaped RBC’s
• Pneumonia: causes cells to be more sickle shaped, which is making all symptoms worse
• Abdominal pain: vascular occlusions, when sickle cells get caught in small vessels
• Low oxygen levels cause RBCs w/ abnormal hemoglobin to undergo sickling
• Hematocrit indicates low # of RBCs –> ability to carry oxygen is reduced –> anemia

Question 4

The man with the yellow eyes - What is the patient’s diagnosis:

Answer 4

Sickle-cell anemia

Question 5

The girl with fruity breath - Signs and symptoms

Answer 5

• Weight loss
• Excessive thirst (polydipsia)
• Excessive drinking & eating
• Fruity breath
• Craving sweets
• Frequent urination (polyuria)
• Increased respiratory rate
• Low BP

Question 6

The girl with fruity breath - Explanation of signs and symptoms:

Answer 6

-Beta cells being destroyed by WBCs, therefore insulin is not being created. If there is no insulin, glucose cannot be converted into energy. Since glucose can’t be converted into energy, her body uses fatty acids as energy. This causes Ketosis (buildup of ketones) and weight loss.

Question 7

The girl with fruity breath - What is ketosis causing?

Answer 7

• Elevated heart & respiratory rate
• Craving sweets
• Fruity smelling breath

Question 8

The girl with fruity breath - What is the patient’s diagnosis?

Answer 8

Diabetes mellitus

Question 9

The girl with relentless pelvic pain - Signs and symptoms:

Answer 9

• Pain during sex, especially before period
• Bleeding between periods
• Inability to become pregnant
• Uterine tenderness
• Mass in right ovary
• Low RBC count, low hemoglobin concentration, and low iron concentration

Question 10

The girl with relentless pelvic pain - Explanation of signs and symptoms:

Answer 10

She has an ovarian lesion and ectopic endometrial on the ovary tissue dies and sloughs off; Adhesions cause obstruction of ovulated egg & sperm, causing infertility; Chronic bleeding: causes decreased iron count and hemoglobin; has retrograde menstruation

Question 11

The girl with relentless pelvic pain - What is the patient’s diagnosis?

Answer 11

Ectopic endometriosis

Question 12

Mammogram: Which image is showing an abnormal mass?

Answer 12

Image 1b

Question 13

Mammogram: Signs that raise suspicion are density, contour, and size of mass or lesion. What are signs of malignancy for each of these?

Answer 13

DENSITY: High density
CONTOUR: Margins of lesion are irregular and only vaguely definable, the border is densely speculated in a star-like pattern
SIZE: Malignant cells often display a faster rate of growth
LESION: A cyst that is non-cancerous

Question 14

Mammogram:Rule of thumb if mammograms show a dense mass?

Answer 14

Any breast mass needs to be evaluated as possible malignancy.

Question 15

Intravenous Pyelorogram: Signs and Symptoms

Answer 15

• Pain in side
• Feels need to urinate most of time
• Blood in urine

Question 16

Intravenous Pyelorogram: Possible causes for symptom? Knowing this, why is an intravenous pyelorogram ordered?

Answer 16

• Obstruction of ureter
• Kidney infection
• Knowing this, the intravenous pylorogram is ordered because the causes and treatments of these conditions are very different and since both conditions can result in severe damage, they must be treated appropriately

Question 17

Intravenous Pyelorogram: What is the patient’s diagnosis?

Answer 17

Unilateral obstructive uropathy with infection

Question 18

Intraoperative Cholangiogram: The patients diagnosis is gallstones. What are the signs and symptoms of gallstones?

Answer 18

• Fever
• Jaundice
• Persistent pain

Question 19

Intraoperative Cholangiogram: What causes gallstones?

Answer 19

If liquid bile contains too much cholesterol, bile salt, or bilirubin it can harden into stones.

Question 20

Intraoperative Cholangiogram: What is a cholecystectomy?

Answer 20

Surgical removal of the gallbladder

Question 21

Intraoperative Cholangiogram: What is a cholangiogram?

Answer 21

X-ray of bile duct system. A readiopaque dye is injected into the patient and will show up at light areas on the x-ray.

Question 22

Intraoperative Cholangiogram: When and why do you do a cholangiogram?

Answer 22

You do a cholangiogram during the surgery to determine if all the stones and stone fragments are removed. If the dye does not go all the way through the bilary duct system, it indicates that there is still an obstruction.