Mary Notsowell presented to Dr Magoo with a significant cramp-like pain and swel
ID: 49310 • Letter: M
Question
Mary Notsowell presented to Dr Magoo with a significant cramp-like pain and swelling in her lower leg. Mary also indicated that she sometimes had mild bone and abdominal pain and fatigue. Dr Magoo’s initial examination found that Mary is a 68-year-old with mild hypertension and a slightly elevated heart rate. His diagnosis was a pulled muscle and osteoporosis. Dr Magoo clearly needs your help with this patient. In the initial round of testing he has missed some important clinically relevant biochemical indicators! You should explore several possibilities.
Mary may have more than one cause for his symptoms with several possibilities. Your task is to:
Discuss each biochemical analyte that could be contributing to the disease/condition and explain what the results of Mary’s blood tests mean in light of her clinical history
Diagnose Mary's symptoms and provide a recommendation on what further tests you would require to confirm your diagnosis if any.
Explanation / Answer
Bone tissue loss disordered the skeletal architecture.Bone mineral density to examine bone loss. BMD with 2.5 SD and more with two or more fractures are signs of severe or established osteoporosis. Markers for bone reodelling like resorption markers serum C-telopeptide (CTX) and urinary N-telopeptide (NTX) and formation markers osteocalcin and seru bone specific alkaline phosphatase to assess the risk factors.
Creatine kinase is the essential marker for muskuloskeletal diseases. creatine kinase involved in the formation of ATP and troponin helps in contractile apparatus. Other studied marker is myoglobin and heavy chain myosin.
Additionally to diagnose heart problem ECG and certain cardiac enzymes like creatine phosphokinase, lactate dehydrogenase, aspartate aminotransferase, and troponin I and T and myoglobin.