Question

Part 1 - Janique Johnson Janique is a 12-year-old female. She is in the 7 grade and has been on the swim team for the past four good student and is generally a happy child. Lately, however, Janique's mother has been worried about ne Janique has been very irritable the past few months and at first Mrs. Johnson just chalked that up to her daughter becoming a teenager. But, in addition to the mood changes. Mrs. Johnson has noted a few other changes in her daughter-Janique is often too tired to attend swimming practice and has complained of feeling too weak and of having headaches. Despite her decreased physical activity. Janique has been eating almost non-stop lost about 5lbs; she is also drinking more than usual and has been vomiting frequently. Janique saw nie physician, and after running some tests, he sent Janique to Dr. Gupta for follow-up. Some blood work and info is in her chart and details are listed below. Result 18.2 130 66 Test BMI (weight: 106 lbs Height: 5'4") Triglycerides (mg/dl) High-density Lipoprotein (mg/dl) Low-density Lipoprotein (mg/dl) Blood Pressure (mm Hg) Pulse Hematocrit (%) Hemoglobin (g/100 ml blood) Glucose (mg/dl) Sodium (mmol/L) Potassium (mmol/L) 85 110/70 60 45 12.8 130 142 Normal Range 18.5-24.9 < 150 240 < 100 90-120/60-80 60-100 36-50 11-14 75-105 135-145 3.5-5.0 4.6

1. What additional information about Jorge and Janique's history would be useful in understanding his situation? Explain your answer

2. What additional test might assist you in understanding Jorge and Janique's situation ? Explain your rationale for your choice(s).

Answer 1

1.The additional information needed are

for Joerge

• Family history of cardiovascular diseases, hypertension,diabetes as his laboratory values are quiet increased to diagnose the condition
• Lifestyles ,diet and exercises as his blood glucose levels are increased
• Any complaints of frequent urination, nocturia, extreme hunger, blurring of vision ,headache ,etc are common in diabetes
• Physical examination assessing the presence of small bumps on the skin ,yellowish discoloration on the lower eye lids to rike out hypercholesterolemia

For Janique

• Family history of diabetes as her blood glucose levels are elevated
• Dietary intakes

2.The additional tests needed are

For Joerge

• Diabetic profile (Fasting ,postprandial, urine routine ,HbA1c levels)
• Liver function test and thyroid hormone to be tested in regards to his obesity

For Janique

• Diabetic profile to rule out juvenile diabetes as it can occur before 14 tears of life in US children