William Cope
Yerko Berrocal
Richard Tapping
Anthony Dwyer
Alisha Punjwani
Dean WatkinsTBL Group 10 - E-Team Based Learning’s Updates
Application Question #2
Question # 2
You obtain a chemistry panel and a creatine kinase level. The creatine kinase is 14,000 U/L (normal < 145 in a female), and the remainder of the chemistry is unremarkable. What additional labs would be most useful at this juncture?
A. complete blood count, erythrocyte sedimentation rate
B. ANA, skeletal muscle glycogen phosphorylase level
C. ANA, anti-SRP, anti-Jo-1, anti-Mi-2
D. anti-Jo-1, erythrocyte sedimentation rate
INSTRUCTIONS
- Step 1: Answer the question, providing medical reasoning to back up your answer. Your answer should be at least 3-5 sentences. DO NOT REFRESH YOUR BROWSER UNTIL YOU HAVE FINISHED YOUR ANSWER.
- Step 2: Now, refresh your browser, and respond to as many others in your team as you can. Responses should provide evidence of your thinking processes (not just "I agree", or "answer is X"). Regularly refresh your browser as others' responses come in.
- Step 3: Based on the discussion recorded in CGScholar, your team reporter should now enter your team's answer in Benware. The whole-class discussion of this application exercise will take place verbally as usual.
C? To confirm that it is polymyositis because it is an autoimmune condition and this would test to see if autoimmunity was the cause
I think the answer is C. It is not A because the blood count is not likely going to tell us much. B would tell us about McArdle's disease. D. I was not sure about. If we are assuming it is polymyosis then ANA will be positive and so will all the others.
ANA is basically looking at antibodies that attack the self
Do you know what ANA is?
for the answer C
I'm really not too sure on this one either, but I would say maybe C. If it is Polymyositis, I don't think there would be noticeable changes in the CBC. The erythrocyte sedimentation rate could help reveal that an inflammatory process is going on, but I don't know how helpful that would be. And it doesn't really sound like McArdle's so I don't know if we would need a glycogen phosphorylase level.
I also vote C
A. An elevated ESR would indicate inflammation, which is consistent with polymyositis. Muscle glycogen phosphorylase is related to McArdle's. Anti-Mi-2 and anti-Jo-1 are antibodies often found in dermatomyositis.
Is there typically an elevated lymphocyte count in polymyositis? I can't remember
These are helpful linking the tests to the possible diagnosis! In this case, I guess A would be best to differentiate between illness and polymyositis.