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Patient Scenario (Upstream/Downstream) Assignment
Addresses Learning Outcomes:
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Use knowledge of biological principles and the Scientific Method to ask and answer relevant
questions about human health and disease

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Analyze information to distinguish between diseased and healthy structure and functioning.

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Analyze how internal and external factors cause disruption of healthy body function, leading to
disease and disorders.

THE SCENARIO:
Mr. Smith is 60 years old. He was diagnosed with prostate cancer five years
ago. Over the past few days, Mr. Smith has been feeling increasingly tired and
has also been suffering from a headache that did not respond to over­the­
counter medications. He scheduled an appointment with his physician.
His physician performed a physical examination and recommended a battery
of laboratory tests and imaging procedures.
His blood pressure is 165/100 mmHg. MRI reveals metastasis of prostate
cancer to osseous tissue. Abdominal CT shows obstruction of intestine due to
nodular enlargement of adrenal glands.
The table below shows Reference values in the right­hand column. These
values reflect the normal range of values for patients without disease or
illness. The center column reflects the resulting values for medical test results
obtained for Mr. Smith.
Take note whether Mr. Smith’s values are within normal limits.

Laboratory results from Mr. Smith’s second hospital admission and medical
tests show following findings:
Mr. Smith

Reference Values

K+

2.6 mmol/L

3.8-4.9mmol/L

Hb

7.3 g/dl

13.8 to 18.2 g/dL

Hct

20.4%

45-52%

Platelet Count

20x109/L

150-400x109/L

HCO3

38 mmol/l

22-26 mmol/L

Urinary K+

70 mmol/L/24 hr

25-120 mmol/L/24 hr

Blood Glucose

460 mg/dl

64.8-104.4 mg/dL

Serum Aldosterone

1 ng/dl

<31 ng>