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2 pages/≈550 words
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APA
Subject:
Biological & Biomedical Sciences
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Essay
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English (U.S.)
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Blood Count and Glucose (Essay Sample)

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Answer questions Below based on this scenario
Mrs. William's. is a 67-year-old housewife, who was admitted to the emergency department complaining of severe chest pain after her daily walk at a nearby park. she received aspirin 300 mg. On arrival at hospital by physical examination and review by the admitting doctor the following information is found.
Previous medical history
Hypertension (17 years). Type 2 diabetes mellitus (4 years ago on metformin ).
The patient is a regular cigarette smoker (>20 per day) and drinks approximately 15 units of alcohol per week. She has osteoarthritis of the knee.
Family history:
Mother died following a myocardial infarction at 70 years of age. No Paternal history of
cardiovascular disease.
Drug history
Allergies: Sulphonamides .
Mrs. Williams. has been taking Ibuprofen200 mg every 12 hours and
nifedipine (Adalat Retard) MR tablets 20 mg (twice daily). Both were stopped on admission.
Signs and symptoms on examination
▪ Temperature 98.1 F
▪ Blood pressure 150/82 mmHg
▪ Heart rate 80 bpm, regular
▪ Respiratory rate 16 breaths per minute
▪ No basal crackles in the lungs.
An ECG taken immediately on arrival reveals ST elevation of 3 mm in the inferior leads. 1 and 2 and AVF
Diagnosis
A preliminary diagnosis of myocardial infarction is made.
Relevant test results
Full blood counts, liver function tests, electrolytes and renal function, CXR, total cholesterol, full
blood count and blood glucose were taken at admission.
1. What further diagnostic and laboratory tests should be ordered to help confirm the
diagnosis?
2. What is myocardial infarction and what are the classic and none classic symptoms?
3. What is the role of thrombolytics such as alteplase in acute myocardial infarction?
4. What is the maintenance dose of Heparin the patient should receive after the initial dose?
5. Patient is going to get atorvastatin daily, what counseling should the patient receive regarding the side-effects of atorvastatin ?

source..
Content:


BLOOD COUNT AND BLOOD GLUCOSE
Name
Institutional Affiliation
Course
Date
BLOOD COUNT AND BLOOD GLUCOSE
1. To confirm the diagnosis of myocardial infarction, further investigations such as cardiac markers, especially Troponin I and T, are crucialADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.4103/0974-2727.54805","ISSN":"0974-2727","abstract":"This article emphasizes on the laboratory investigations that may play a significant role in the prompt management of the patient. Hence, other conditions where laboratory investigations will not play a major role are not included in this article. An attempt has been made to highlight certain issues wherein we can prevent inadvertent ordering of tests to minimize the burden on the overworked emergency laboratory, without compromising patient care. The conditions that will be dealt here include: acute chest pain, acute abdominal pain, road traffic injuries, acute respiratory distress, high grade fever, vomiting, loss of consciousness, poisoning and laboratory accidents, and lastly occupational exposure to potential biological hazards.","author":[{"dropping-particle":"","family":"Gupta","given":"Swati","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Laboratory Physicians","id":"ITEM-1","issue":"01","issued":{"date-parts":[["2009"]]},"page":"027-030","title":"Laboratory Approach to the Management of Clinical Emergencies: A Diagnostic Series","type":"article","volume":"1"},"uris":["http://www.mendeley.com/documents/?uuid=80aed300-4ed4-40b7-b7bc-b718538bb9d8"]}],"mendeley":{"formattedCitation":"(Gupta, 2009)","manualFormatting":"(Gupta, 2019)","plainTextFormattedCitation":"(Gupta, 2009)","previouslyFormattedCitation":"(Gupta, 2009)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Gupta, 2019)ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"id":"ITEM-1","issued":{"date-parts":[["0"]]},"title":"RCPA - Myocardial infarction","type":"article"},"uris":["http://www.mendeley.com/documents/?uuid=3a9da660-a2a5-4d8b-8300-3d980323a9b2"]}],"mendeley":{"formattedCitation":"(RCPA - Myocardial Infarction, n.d.)","plainTextFormattedCitation":"(RCPA - Myocardial Infarction, n.d.)","previouslyFormattedCitation":"(RCPA - Myocardial Infarction, n.d.)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(RCPA - Myocardial Infarction, n.d.). These markers are highly sensitive in showing the presence of an acute myocardial injury and necrosis. In addition, chest radiology can be done and can illustrate pneumothorax, pneumonia, and even left-sided heart failure. Using computer tomography will facilitate the exclusion of non-ischemic causes of chest pain. Other critical tests are C reactive proteins levels and other markers of inflammations and stress test. Lastly, the glycosylated hemoglobin (Hb1c) levels to ascertain whether the client's blood sugars were well controlled for the past three months.
2Myocardial infarction is commonly known as a heart attack. It is caused by decreased, or impaired blood flow to a segment of the myocardium. Deprivation of the myocardium with oxygen results in myocardial cell necrosis and deathADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Mechanic","given":"Oren","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Grossman","given":"Shamai","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"StatPearls Publishing","id":"ITEM-1","issued":{"date-parts":[["2020"]]},"title":"Acute Myocardial Infarction - StatPearls - NCBI Bookshelf","type":"article"},"uris":["http://www.mendeley.com/documents/?uuid=951f9554-3f11-4cf4-bfc5-5210eba0d4fa"]}],"mendeley":{"formattedCitation":"(Mechanic & Grossman, 2020)","plainTextFormattedCitation":"(Mechanic & Grossman, 2020)","previouslyFormattedCitation":"(Mechanic & Grossman, 2020)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Mechanic & Grossman, 2020). The usual classic symptoms of myocardial infarction include a sudden sharp chest pain radiating to the jaw, arm, and neck that is unrelieved even at rest, chest tightness, and shortness of breath. The chest pain may few minutes and recur with time. Besides, the other symptoms that a patient may present with are nausea, vomiting, sweating, tachycardia, lightheadedness
1 Thrombolytic therapy, also known as thrombolysis or fibrinolytic therapy, is the treatment given to dissolve intravascular clots that cause ischemic attacks by impairing blood flow. A thrombosis formation is a normal physiologic response due to vascular injury. However, when this clot enters the circulation is called an embolus and has a risk of causing ischemic attacks in vital organs. Alteplase is a recombinant plasminogen activator that is fibrin-specific. It plays a crucial role in the fibrinolysis of clots, preventing impending myocardial infarction, pulmonary embolism, and other acute cardiovascular eventsADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"id":"ITEM-1","issued":{"date-parts":[["0"]]},"title":"Thrombolytic Therapy - StatPearls - NCBI Bookshelf","type":"article"},"uris":["http://www.mendeley.com/documents/?uuid=9b1df43e-26c5-4963-9171-9be5effeea01"]}],"mendeley":{"formattedCitation":"(Thrombolytic Therapy - StatPearls - NCBI Bookshelf, n.d.)","plainTextFormattedCitation":"(Thrombolytic Therapy - StatPearls - NCBI Bookshelf, n.d.)","previouslyFormattedCitation":"(Thrombolytic Therapy - StatPearls - NCBI Bookshelf, n.d.)"},"properties":{"noteIndex":0},"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"}(Thrombolytic Therapy - StatPearls - NCBI Bookshelf, n.d.). Once the clots are dissolved, blood flow to ischemic areas is improved, preventing MI or deterioration of MI. However, this therapy should be given as soon as possible to prevent the adverse effects of ischemia

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