 |  IM-3..A 68 yr old lady..
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| Author | 7 Posts |
rashmi_k3
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A 68 year old lady presents to you with left sided hearing impairment. She says that she cannot put the phone on her left ear because it hurts. You perform a physical exam and see that the pinna is not tender but she winces when you put the vibrating tuning fork to her left ear.
You perform a skull X-ray that shows skull bone to be of two different densities. You go on and do a complete lab work up.
CBC shows a white count of 9.2, Hb of 13.4, Platelet count of 389K. Differential count is normal. Sodium is 143, Potassium is 3.9, Chloride is 101, HCO3 is 25, BUN 20 and creatinine is 1.1. Albumin 4.1., Globulin 3.0, AST 38, ALT 20, ALP 349, GGT normal, Bilirubin 0.9mg%.
Q.Which of the following tests would be most appropriate to detect the origin of the ALP at this point?
a.GGT (gamma glutamyl transferase)
b.Rectal examination
c.Heat lability of ALP
d.Bence Jones proteinuria
e.Auditory evoked potential
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| mdwannabe
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C... will differentiate bone source from the rest.
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| rashmi_k3
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correct
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| mdwannabe
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:-)
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"Life not lived for others, is not worth living" Uncle Einstein
"A life is not important, except in the impact it has on other lives" -Jackie Robinson
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| ELM
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:lol: Hi MDWB,
Even you have said you done with me.....i dare to ask why you chose c is the correct answer??
How heat lability of ALP could diffirentiate bone source from others ...if you willing to reply???
Thank you!
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ELM
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| mdwannabe
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Ofcourse I could send you to do your home work, like you did to me, but I don't take your comments personally, no matter how hard you may try.
In any case... Bone Alk Phos, is heat labile, while most of other such as WBC, Kidney, Liver...are heat stable. If I am not mistaken...at 60 deg Cel, Bone Alk Phos denaturates.
Hope this helps.
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"Life not lived for others, is not worth living" Uncle Einstein
"A life is not important, except in the impact it has on other lives" -Jackie Robinson
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| ELM
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Topics: 28
Posts: 936
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I truely haven't tried hard yet :lol: ........but thank you for your replies!
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ELM
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