Compare Mr. Smiths values with reference values and indicate whether MR. Smiths values are below above or within normal range
Mr. Smith is 60 years old. He was diagnosed with a prostate cancer five years ago. Over the past few Show more Mr. Smith is 60 years old. He was diagnosed with a prostate cancer five years ago. Over the past few days Mr. Smith has been feeling weak and increasingly tired and has also been suffering from a headache that did not respond to over-the-counter medications. He scheduled an appointment with his physician. His physician performed a physical examination and recommended a battery of laboratory tests and imaging procedures. The table below shows Reference values in the right-hand column. These values reflect the normal range of values for patients without disease or illness. The center column reflects the resulting values for medical test results obtained for Mr. Smith. Take note whether Mr. Smiths values are within normal limits. Mr. Smith Reference Values K+ 2.6 mmol/L 3.8-4.9mmol/L Hb (Hemoglobin) 7.5 g/dL 13.8 to 18.2 g/dL Hct (Hematocrit) 20.4% 45-52% Platelet Count 4910 9 /L 150-40010 9 /L After receiving Mr. Smiths test results his physician admits him to the hospital. Hospital staff treated him and discharged him. The following week Mr. Smith returns to his physician with the same complaint of weakness and a new complaint of shortness of breath. His blood pressure is 160/100 mmHg. MRI reveals metastasis of prostate cancer to osseous tissue. Abdominal CT shows obstruction of intestine due to nodular enlargement of adrenal glands. Laboratory results from Mr. Smiths second hospital admission and medical tests show following findings: Mr. Smith Reference Values K+ 2.6 mmol/L 3.8-4.9mmol/L Hb 7.3 g/dl 13.8 to 18.2 g/dL Hct 20.4% 45-52% Platelet Count 2010 9 /L 150-40010 9 /L HCO3 38 mmol/l 22-26 mmol/L Urinary K+ 70 mmol/L/24 hr 25-120 mmol/L/24 hr Blood Glucose 460 mg/dl 64.8-104.4 mg/dL Serum Aldosterone 1 ng/dl 24 hour Urinary Aldosterone 8.4 mcg/24 hr 2.3-21.0 mcg/24 hr Renin 2.1 ng/ml/hr 0.65-5.0 ng/ml/hr ACTH (Adrenocorticotropic Hormone) 1082 pg/ml 9-46 pg/ml Cortisol 155.5 microg/dL 0-25 microg/dL CONCLUSION AND DIAGNOSIS Laboratory findings MRI and CT confirmed metastatic prostate adenocarcinoma hypertension and refractory hypokalemia due to ectopic ACTH production. High levels of circulating cortisol caused continuous activation of mineralocorticoid receptors resulting in hypokalemia metabolic alkalosis and hypertension. QUESTION: Compare Mr. Smiths values with reference values and indicate whether MR. Smiths values are below above or within normal range (compare Mr. Smiths values with the Reference values) for each laboratory tests in the table above from the second set of tests. Show less
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