! What Does It Test For? Very Low Low Glucose Electrolytes Ferritin Blood ph The glucose test measures the amount of sugar, or glucose, in the blood or urine. A very high or very low glucose test can indicate an issue with the body processing glucose to obtain energy. Red or dark Pink or orange An electrolyte test measures the levels of substances, such as carbon dioxide, sodium, and potassium. Low levels can indicate dehydration, and low or high levels can also indicate issues with the kidneys. Ferritin is a protein that stores iron. High levels can indicate iron storage disorders, while low levels can indicate iron deficiency, which can cause anemia. Possible Results! The blood ph test determines whether the blood is acidic (low) or alkaline (high). The normal ph of blood is between 6.8 and 7.8. Certain medical conditions can create more acidic or alkaline levels. The liver is an important organ that detoxifies the body using several enzymes. Low levels of liver enzymes can indicate inadequate liver function, while high levels can indicate blockage or overexertion of the liver. Bright Bright ; fades to white Normal Blue Pink High ; fades to white Pink or light purple Very High Blue Red blood cells fight off infection in the body. A high white blood cell level indicates the presence of infection in the body, while a low count indicates the possibility of diseases that reduce white blood cell production in bone marrow. Dark or black orange or yellow Dark or black Dark or red! 45
Patient Interview Chief Complaint The patient is a 56-year-old female complaining of an extremely itchy rash covering the chest area. The rash has been present for over a month. The patient also complains of a painful lump in the armpit. Patient Image A. Persistent chest rash Other Pertinent Information The patient returned from vacation in Thailand approximately a month and a half ago The patient works on a chicken farm Signs & Symptoms Red, itchy chest rash Painful lump in left armpit Muscle and chest pain Feels feverish, especially at night (night sweats) Fatigue Physical Exam Vital signs: all vital signs are normal Height: 5 3, Weight: 170 lbs. The chest rash is slightly raised, red, scaly, and covers approximately 75% of the chest (see Patient Image A) A lump approximately 30 cm in diameter can be palpated (felt) in the left armpit Patient experienced a pain level of 8 on a scale of 1-10 (1 = no pain, 10 = severe pain) during palpation Refer to teacher information sheet for image source Medical History Patient No history of rash or chest pain Patient complains of frequent fatigue over the last 5 years Patient was not vaccinated as a child with the MMR vaccine Family Grandfather and grandmother had diabetes early in life Father has eczema Mother is a breast cancer survivor! 47
Possible Diagnoses Breast Cancer Breast cancer is a type of cancer that develops from breast tissue. It can be hereditary or caused by environmental carcinogens. Breast cancer often has no symptoms, but it can cause swelling in the breasts, swollen lymph nodes, skin rash on the chest, itching, chest pain, and/or fatigue. Most breast cancer cases are found in women over the age of 50. Eczema Eczema is inflammation or irritation of the skin. It can be caused by allergies and is considered to be hereditary. Symptoms include a red-patched rash, itching, fatigue, thickened skin, and/or pain at the rash site. Eczema affects all ages. Diagnostic Test Results Glucose Electrolytes Ferritin (Iron) Blood ph orange or yellow Rubella Rubella is a highly contagious disease caused by a viral infection. The MMR vaccine, administered in childhood, protects an individual from contracting Rubella. Symptoms include a blotchy skin rash, swollen glands, light sensitivity, fatigue, and a low fever. Rubella is more common in third world countries, children, and unvaccinated adults. Histoplasmosis Histoplasmosis is a fungal infection caused by breathing in fungus spores that can be found in bat and bird droppings. Symptoms include fever, chest discomfort, fatigue, muscle pain, and a red rash. Histoplasmosis affects all ages, but farmers, landscapers, and individuals who work around animal droppings are at a higher risk. Pink or orange Dark purple Dark or red Dark or red 48!
Patient Interview Chief Complaint The patient is a 5-year-old male that has been brought into the emergency room unconscious. The parents believed the son had the flu, and he was complaining of not being able to see very well before he became unconscious. The parents also note that the child has been extremely thirsty over the past 2 days. Patient Image B. Patient in emergency room for treatment Other Pertinent Information The parents commented on their son being confused about where he was before he became unconscious Signs & Symptoms Cough with congestion Body aches Weight loss Vision impairment Fatigue Physical Exam Vital signs: heart rate and blood pressure are high, skin is hot and dry Height: 3 3, Weight: 32 lbs. The patient is in and out of consciousness No visual abnormalities are noticed Refer to teacher information sheet for image source Medical History Patient Parents stated that patient is often ill Family Patient s uncle has mild cystic fibrosis Patient s great-grandmother had type 1 diabetes! 49
Possible Diagnoses Cystic Fibrosis Cystic fibrosis is a genetic condition where the lungs and pancreas overproduce mucus. Symptoms include a persistent cough, thick mucus, lung infections, intestinal blockage, weight loss, and dehydration. Severe cystic fibrosis can be life threatening. Cystic fibrosis is normally diagnosed in childhood. Diagnostic Test Results Glucose Electrolytes Ferritin (Iron) Blood ph Dark Influenza Influenza, or the flu, is a contagious respiratory illness caused by a virus. Symptoms include cough, congestion, body aches, fatigue, and weight loss. Severe flu can cause pneumonia and/or coma. The flu can be very mild or so severe that it can lead to death. Type 1 Diabetes Type 1 diabetes is a genetic condition in which the pancreas does not create enough insulin. Symptoms of type 1 diabetes include excessive urination, excessive thirst, weight loss, dehydration, blurry vision, increased appetite, and fatigue. Severe symptoms can cause confusion and even coma. Type 1 diabetes is normally diagnosed in childhood. Kidney Failure Kidney failure occurs when the kidneys stop working. This can occur due to serious infection, poisons, or a blockage. Symptoms include a lack of urination, dehydration, swelling, back pain, fatigue, confusion, and eventual coma. Kidney failure can be acute (immediate) or chronic (long-term). Kidney failure affects all ages, but is more common in older adults. Blue or orange! orange or yellow 50!
Patient Interview Chief Complaint The patient is a 21-year-old female who is experiencing severe chest and abdominal pain. She called an ambulance to bring her to the hospital because she believes she is having a heart attack. She has experienced milder chest and abdominal pain over the last 3 weeks. Other Pertinent Information The patient feels the worst after eating large meals Patient Image C. Endoscopy images: (A) upper small intestine with inflammation, (B) lower normal small intestine Signs & Symptoms Abdominal pain Chest pain Bloating Weight loss Nausea Vomiting Dark colored stool Physical Exam Vital signs: low blood pressure, high respiration rate Height: 5 9, Weight: 145 lbs. Patient appears extremely distressed An endoscopy was performed. Inflammation and erosion were present in the upper small intestine (see Image C) Patient is experiencing a pain level of 10 on a scale of 1-10 (1 = no pain, 10 = severe pain) Refer to teacher information sheet for image source Medical History Patient Has experienced similar mild abdominal pain three times in the past 2 years, but it has never been this severe Family Father has sickle cell anemia Mother had surgery to remove gallstones when she was 35 years old! 51
Possible Diagnoses Ulcers Ulcers are painful sores in the lining of the stomach or small intestine. Ulcers can be caused by stress, infection, or overuse of certain medications. Symptoms of ulcers include severe chest or abdominal pain, heartburn, bloating, nausea, vomiting, blood in stool, and weight loss. Gallstones Gallstones are hard deposits of cholesterol in the gallbladder. Gallstones can cause symptoms when they block the duct from the gallbladder leading into the intestines. Symptoms include severe chest or abdominal pain, yellowing of skin or whites of eyes (jaundice), heartburn, fever, chills, nausea, vomiting, strangely colored stool, and dark urine. Gallstones are more common in older, overweight adults. Irritable Bowel Syndrome Irritable bowel syndrome (IBS) occurs when the gastrointestinal tract becomes inflamed. Symptoms include abdominal pain, cramping, bloating, nausea, gas, diarrhea, constipation, weight loss, and mucus in stool. IBS is more common in adults, but can affect all ages. Sickle Cell Anemia Sickle cell anemia is a genetic condition that causes red blood cells to be sickle-shaped, and therefore have issues carrying oxygen through the body. Symptoms include periodic chest and abdominal pain, joint pain, anemia, swelling of hands and feet, frequent infections, bloating, slow body growth, and vision issues. Sickle cell anemia is often diagnosed in childhood, but some individuals will have very mild symptoms. Diagnostic Test Results Glucose Electrolytes Ferritin (Iron) Blood ph Pink or orange Blue, fades to Blue Pink, fades to white Pink, fades to white Dark Dark Dark 52!
Patient Interview Chief Complaint The patient is a 56-year-old male who was brought to the hospital by his daughter after appearing confused, and was unable to stand. Patient is complaining of abdominal swelling, pain, and fatigue. Patient Image D. Patient with distended abdomen Other Pertinent Information Patient has abused alcohol for the past 20 years Patient stated that his drinking buddy was recently diagnosed with Hepatitis C Signs & Symptoms Fatigue Abdominal pain Weight loss Jaundice Confusion Rash on abdomen (see Image D) Swollen (distended) abdomen (see Image D) Physical Exam Vital signs: low pulse, low blood pressure, low respiration rate, skin is yellow in color Height: 6 0, Weight: 168 lbs. The abdomen is distended with small, red blotchy rash (see Image D) Patient experienced a pain level of 4 on a scale of 1-10 (1 = no pain, 10 = severe pain) during palpation of the abdomen Refer to teacher information sheet for image source Medical History Patient Patient has been admitted to the hospital 8 times in the past 15 years due to injuries or illness related to alcohol abuse Family Aunt has been diagnosed with hemochromatosis! 53
Possible Diagnoses Mononucleosis Mononucleosis is caused by a virus, and can last weeks or even months. Symptoms include fatigue, muscle aches, yellowing of the skin (jaundice), tiny red spots on the skin and in mouth, fever, sore throat, abdominal pain, and swollen lymph nodes. Mononucleosis can infect all ages. Hepatitis Hepatitis is caused by a virus that infects the liver. Symptoms include joint pain, nausea, vomiting, abdominal pain, fatigue, yellowing of the skin (jaundice), internal bleeding, abdominal swelling, nausea, vomiting, confusion, and mild fever. There are actually three viruses that cause hepatitis A, B, and C with hepatitis C being the most severe. Hepatitis can infect all ages. Hemochromatosis Hemochromatosis is a genetic condition that causes iron to build up in the body. Symptoms include joint pain, weight loss, fatigue, abdominal pain, abdominal swelling, and abnormal skin spots or color. Over time, hemochromatosis can cause cirrhosis. Hemochromatosis can be diagnosed in childhood, but symptoms do not appear until later in life. Cirrhosis Cirrhosis occurs when scar tissue replaces healthy liver tissue, preventing liver function. Symptoms include abdominal swelling, yellowing of the skin (jaundice), swelling of the hands and feet, small red spots or lines on the skin, weight loss, abdominal pain, frequent infections, fatigue, easy bruising, nosebleeds, and confusion. Cirrhosis is most common in adults who have abused alcohol, have a fatty liver from obesity, or have hepatitis. Diagnostic Test Results Glucose Electrolytes Ferritin (Iron) Blood ph Pink Pink Blue Pink, fades to white or orange Dark Dark Dark Dark Dark Dark Dark Dark or red 54!
Patient Interview Chief Complaint The patient is a 16-year-old male complaining of a severe cough, chest pain, and shortness of breath. His parents also noticed he has been losing weight over the past 2 weeks. Patient Image E. Patient chest x-ray; congestion can be seen in red Other Pertinent Information The patient spent the summer with his family in India Signs & Symptoms Fatigue Severe cough Congestion with blood occasionally in mucus Weight loss Slight fever Shortness of breath Chest pain Physical Exam Vital signs: high respiration rate, skin warm to touch Height: 5 11, Weight: 155 lbs. A chest x-ray shows congestion and/or a mass in the upper left lung (see Image E) Patient experienced a pain level of 5 on a scale of 1-10 (1 = no pain, 10 = severe pain) Refer to teacher information sheet for image source Medical History Patient Patient has no history of similar illness Family Family members have no history of similar illness! 55
Possible Diagnoses Atherosclerosis Atherosclerosis is the narrowing and/or blockage of arteries, which can lead to stroke and heart attacks. Atherosclerosis in the arteries that feed the heart is called coronary artery disease. Symptoms include chest pain, pain in the limbs, fatigue, shortness of breath, and poor wound healing. Atherosclerosis is most common in adults over the age of 60, and can be more severe in those who have led an unhealthy lifestyle. Tuberculosis Tuberculosis is a bacterial infection most commonly infecting the lungs. Symptoms include fatigue, cough, bloody mucus, weight loss, fever, shortness of breath, chest pain, and night sweats. Tuberculosis can infect all ages, but most commonly develops in individuals with weakened immune systems or the elderly. Infections are more common in third world countries. COPD Chronic obstructive pulmonary disease (COPD) is a group of lung diseases that block the flow of air through the lungs. This makes breathing difficult. Symptoms include shortness of breath, chest pain, cough, frequent infections, fatigue, and weight loss. COPD is most common in smokers. Asthma Asthma is the inflammation of the bronchial tubes that lead to the lungs. Asthma also produces additional mucus that can block the airways. Symptoms include cough, wheezing, shortness of breath, chest pain, chest pressure, and fatigue. Asthma can affect all ages, but asthma attacks can be more severe in children. Diagnostic Test Results Glucose Electrolytes Ferritin (Iron) Blood ph Blue Pink, fades to white or orange Dark Dark or red 56!