Fever and Chills Homework Brian is a 64yearold male with a c

Fever and Chills Homework Brian is a 64-year-old male with a chief complaint of left hip pain that occurred after skiing. Left hip X-rays reveal multiple osteolytic lesions. Subsequent X-rays were taken of other skeletal regions with multiple osteolytic lesions found as well. Brian does state that over the years he has become more lethargic and has felt overall muscle weakness. Blood smear determines RBCs to be normocytic and normochromic.

The lab values are as follows:

Blood pressure: 128/83

Respiratory Rate: 14

RBC: 3.1 million/mm3

WBC: 6230/mm3

Platelet count: 190,000/ mm3

Na+: 143 mEq/L

Ca++: 18 mEq/L 1.

Evaluate the lab values (normal, high, low)

Blood pressure:

Respiratory Rate:

RBC:

WBC:

Platelet count:

Na+:

Ca++:

2. List 3 differential diagnoses and include your reasoning behind each.

3. What is the best diagnosis? Explain how you came to this conclusion.

4. Explain the pathophysiology of the following signs/symptoms:

Osteolytic lesions:

Lethargy and muscle weakness:

5. Explain what other findings may be found in Brian’s blood sample in regard to his condition?

Solution

Blood pressure: 128/83 --> higher than normal systolic & diastolic blood pressure

Respiratory Rate:1 ---> normal

RBC: 3.1 million/mm^3 --> Count is lower compared to normal

WBC: 6230/mm^3 ---> lower compared to the normal

Platelet count: 190,000/mm 3 ---> normal coagulation factors

Na + : 143 mEq/L ---> normal natrium levels in the blood

Ca ++ : 18 mEq/L ---> high levels of calcium compared to the normal

2. List 3 differential diagnoses and include your reasoning behind each.

Brian has “Multiple myeloma” because of damage to the bone caused by multiple osteolytic lesions

Hypercalcemia & lethargy is due to excess bone calcification and damage due to lesions

His blood tests have revealed anemia, thrombocytopenia

3. What is the best diagnosis? Explain how you came to this conclusion.

Myeloma cancer is best diagnosis report obtained from this lab reports because of low RBC and low WBC due to his blood tests have revealed anemia (Hemoglobin= 8 g/dl) caused by multiple osteolytic lesions