Please review the following document and post your responses in
Please review the following document and post your responses in the discussion. Be sure to include rationales and references. Module 4 Case Studies Case #1 An 18-year-old man (B.H.) has been training for a marathon for the last 4 months. He is noticing his stamina decreasing during his runs over the last couple months. This concern is the reason he scheduled an appointment at the clinic last week. The NP working that day ordered the following labs and he is returning today to review his lab work. The only medications he has been taking are over-the-counter vitamins, vitamin B12, and iron supplement. He denies any alcohol or drug usage. Appetite is good with a balanced diet. He denies weight loss or gain. His physical exam was normal with a BMI of 23. His CBC yielded the following results: TEST RESULTS REF. RANGE* CONVENT. UNITS SI UNITS CONVENT. UNITS WBC 9.5 x 103/ml 9.5 x 109/l 4.8-10.8 x 103/ml RBC 5.35 x 106/ml 5.35 x 1012/l 4.2-5.4 x 106/ml Hgb 10.5 g/dl 105 g/l 14.0-18.0 g/dl (male) Hct 36.0% 360 l/l 42-52% (male) MCV: 67 fl 67 fl 80-99 fl MCH: 19.6 pg 19.6 pg 27-31 pg MCHC: 29.2 g/dl 292 g/l 33-37 g/dl RDW: 14.2% 11.5-14.5% Platelets 260 x 103/ml 260 x 109/l 130-400 x 103/ml MPV 10.5 fl 7.4-10.4 fl *Harmening (Ref. 1) Answer the following questions: 1. What are your differential diagnoses – list your top five (5) 2. Identify your rationale for selecting the differentials you identified 3. What additional labs/tests would you order to assist in the diagnosis? 4. Explain your reason for ordering each of the labs/tests you are ordering Case #2 For each of the four (4) Rows below, identify a potential diagnosis and treatment for each of the lab values in each of the four (4) rows. RDW Serum Iron TIBC Ferritin #1 Inc Dec Inc Dec #2 Nor Dec Dec Inc #3 Inc Inc Nor Inc #4 Nor Nor Nor Nor Possible Diagnoses & Treatment for: #1 #2 #3 #4
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