Clinical cituation 1

The patient complains on the weakness, drowsiness, fatigue, a nausea, periodic vomiting, loss of appetite, down to disgust for food, a painful skin itch, gastroenteric bleedings, subcutaneous hemorrhage , fast decrease reduction in weight of body, muscular twitching and spasms without loss of consciousness, the big noisy breath, pains in bones, joints.

Biochemical test of blood:

Urea – 15 mmol/l

Uric acid – 0,78 mmol/l

Creatinine – 135 mcmol/l normal – 44-100 mkmol/l

The acid- balance (the content of acidic products) – 56 mmol/l normal -23-33 mmol/l

Ca – 1,8 mmol/l

Phosphates – 4 mmol/l

Magnesium – 1,6 mmol/l normal – 0,7-1,2 mmol/l

K – 2,3 mmol/l

The general analysis of blood:

Leukocytes – 9*10⁹/l with neutrophilic shift to the left

Erythrocytes or red blood cells – 4*10 ¹²/l

Hemoglobin – 80 g/l

Time of blood clotting – 12 min.

Erythrocyte sedimentation rate ESR – 10 mm/h

Trombocytopenia

The urine analysis (urine examination):

Diurnal diuresis (diurnal urine exertion) - 800 ml

pH is – alkaline

Color – pale - yellow

Specific gravity – 1,008

At what pathology the specific changes in analyses of blood and urine can be observed? Name these changes, explain the reasons of their appearances.

Clinical cituation 2

The patient of 50 years complains on colicky pain in the right leg, chill and feeling numbness stupor extremities. At walking the is compelled stop, then the pain abates an alternating lameness. Recently on fingers of the right leg trophic ulcers have appeared.

Biochemical blood test:

The total cholesterol – 10,3 mmol/l

Free cholesterol – 6,18 mmol/l in normal – 30 % from the general cholesterol

Esters of cholesterol – 4,12 mmol/l in normal – 70% from the general cholesterol

Triglycerides – 5,00 mmol/l normal – 3,27 mmol/l

The ratio of phospholipids to cholesterol – 0,8:1,7 normal -1,5:1,0

The general analysis of blood:

Leukocytes – 4*10⁹/l

Erythrocytes or red blood cells – 4*10 ¹²/l

Hemoglobin – 145 g/l

Time of blood clotting – 2 min.

Erythrocyte sedimentation rate ESR – 8 mm/h

The urine analysis (urine examination):

Diurnal diuresis (diurnal urine exertion) – 1.8 ml

pH is –slightly - acidic

Color – straw-yellow

Specific gravity – 1,029

Protein – is absent

The formed elements – are absent

At what pathology the specific changes in analyses of blood can be observed? Name these changes, explain the reasons of their appearances . Specify on possible interrelation between complaints of the patient and the found out changes.

Clinical cituation 3

Mother of the five-monthly girl complains, that the child becames restless, shudders at a loud sound, flash of light, dream of the child superficial, disturbing. It is marked increased sweating, sweat secretion, perspiration, it is especial at shout, feeding. Sweat has a unpleasant source smell, irritates a skin, causes an itch. The child rubs the head about a pillow, hair on a hape are wiped. Has appeared miliaria, are marked the changes on the part of bone system, a softening of an occipital bone, a curvature of tubular bones of extremities .

Biochemical parameters of blood (of serum):

Ca - 1,4 mmol/l

P - 0,7 mmol/l

Activity of alkaline phosphatase – 980 mmol/l , normal – 278-830 nmol/l

The acid- base balance 45 mmol/l, normal –23-33 mmol/l

The general analysis of blood:

Leukocytes – 5*10⁹/l with neutrophilic shift to the left

Erythrocytes or red blood cells – 4*10 ¹²/l

Hemoglobin – 130 g/l

Erythrocyte sedimentation rate ESR – 10 mm/h

At what pathology the specific changes in analyses of blood can be observed? Name these changes, explain the reasons of their occurrence.

Clinical cituation 4

The man of 48 years complains on the occurrence of pressing intensive pains in epigastria areas which were distributed in retrosternal area, rise in temperature, sharp weakness, dizziness, a nausea, numerous vomiting.

Biochemical parameters of serum of blood:

Activity of dehydrogenase – total – 32.000 nmol/l, normal – 3.200 mmol/l

On share of LDH1 48% are necessary /, normal – 19-29%

On share of LDH2 41% are necessary /, normal-23-37%

LDH1/LDH2=1.0 in norm the ration is equal 1.0

Activity of aspartate aminotransferase AST – 1319 nmol/l,normal 30-420 nmol/l

Activity of creatine kinase CK – 500 nmol/,normal – up to 100 nmol/l

AST/ALT – 4.21 / normal – 1.33

The general analysis of blood:

Leukocytes – 10*10⁹/l

Erythrocytes or red blood cells – 4*10 ¹²/l

Hemoglobin – 150 g/l

Erythrocyte sedimentation rate ESR – 8 mm/h

The urine analysis (urine examination):

Diurnal diuresis (diurnal urine exertion) – 1.8 ml

pH is – slightly -acidic

Color – straw-colored

Specific gravity – 1,026

Protein – is absent

The formed elements – are absent

At what pathology the specific changes in analyses of blood can be observed? Name these changes, explain the reasons of their appearances.