CHAPTER 12 ENZYMES 297 CASE STUDY 12-2 While a 71-year-old woman is walking home
ID: 128942 • Letter: C
Question
CHAPTER 12 ENZYMES 297 CASE STUDY 12-2 While a 71-year-old woman is walking home froma shopping center, she faints and falls. She is driven home by a friend. When home, she realizes that she is bleeding from her mouth and is slightly disori- ented. She appears injured from the fall, but she does not remember tripping or falling. The woman is taken to a local emergency department. The examin- ing physician determines that there was a loss of consciousness; to determine the reason, he orders a head CT and ECG and the following laboratory tests CBC, PT, aPTT, CK, LDH, AST, and troponin T and troponin I. All tests are within normal limits. The woman is sutured for the mouth injuries and admit- ted to a 24-hour observation unit. Questions 1. What possible diagnoses is the physician consid- ering? and 24 hour if this patient had an AMI? patient? 2. What laboratory tests would be elevated at 6, 12, 3. What isoenzyme tests would be useful with thisExplanation / Answer
The patient had fall and fainting , the possible diagnosis would be AMI, acute myocardial infraction.
The doctor expected to get an elevated levels of CK in 24 hours time. In myocardial infraction, the CK release from injured myocardial cells into blood is expected within 6-8 hours and it peaked in 24hour.
The useful iso enzyme test for this patient include Creatinine Kinase (CK) , CK- MB, troponin T and troponin I.