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Case 4: A 30-year-old male was brought to the ER with chest pain after a softbal

ID: 58563 • Letter: C

Question

Case 4:

A 30-year-old male was brought to the ER with chest pain after a softball game. He was placed in the coronary care unit when his ECG showed erratic waves in the ST region. A family history revealed that his father died of a heart attack when he was 45 years old. The patient had always been athletic in high school and college, so he had not concerned himself with a routine physical.

Questions:

1.Give at least 3 different diagnoses that this patient may be suffering from.

2.After inspection of the lab tests below, what is the most probable diagnosis taking into account the family history

Chemistry

Glucose

97

Cholesterol

278

BUN

20

Uric Acid

5.9

Creatinine

1.1

Total Bilirubin

0.8

Sodium

139

AST

35

8-40 IU/L

Potassium

4.1

ALP

20

7-60 IU/L

Chloride

101

LD

175

90-190 IU/L

HCO3

29

Amylase

98

76-375 IU/L

Total Protein

6.9

Albumin

3.2

Calcium

9.3

3.Given the symptoms and the family history, what additional tests should be recommended?

4.If his follow-up total cholesterol remains in the same range after he has been released from the hospital and his triglycerides and HDL cholesterol are within normal range, what course of treatment should be recommended?

Please answer all 4 case study questions

Chemistry

Glucose

97

Cholesterol

278

BUN

20

Uric Acid

5.9

Creatinine

1.1

Total Bilirubin

0.8

Sodium

139

AST

35

8-40 IU/L

Potassium

4.1

ALP

20

7-60 IU/L

Chloride

101

LD

175

90-190 IU/L

HCO3

29

Amylase

98

76-375 IU/L

Total Protein

6.9

Albumin

3.2

Calcium

9.3

Explanation / Answer

1.Due to erractic waves in ECG, patient could be suffering from coronary heart disease, hypotention , artherosclerosis.

2. Cholesterol levels seems to be in abnormal range.

3.Additional tests recommended: HDL level and LDL level , (High Density Lipoprotein and Low Density Lipoprotein)

4. He should undergo lifestyle changes, with regard to diet, and also check for diabetes

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