Ans: Increase in blood urea and creatinine indicates renal failure. The commonest
cause of hyperphosphatemia is renal failure. High phosphate levels in this case
indicate a severe degree of renal insufficiency. High phosphorus interferes
with calcium absorption, resulting in hypocalcemia and renal osteodystrophy.
39.8 Case Studies of Cardiac Functions
Q.1. A 55-year-old man was complaining of chest pain and labored breathing.
The laboratory blood examination report was:
CK–690 U/L
CK-MB–88 U/L
AST–90 U/L
LDH–785 U/L
Cholesterol–360 mg/dl
HDL cholesterol–35 mg/dl
LDL cholesterol–260 mg/dl
Comment on report.Ans: In acute myocardial infarction,chestpain is the commonest symptom. Pul-
monary edema is the consequence of damage to the heart limiting theoutput
of theleft ventricleand shortening of breath. Here, the serum levels of CK,
CK-MB, AST, and LDH are increased which suggest myocardial infarction.
The serum cholesterol and LDL cholesterol levels are very high, while HDL
levels are decreased which predispose a person to heart disease.
Q.2. A 58-year-old man with known diabetic history since the last 12 years
underwent laboratory examination. The blood test results showed that his
AST, ALT, urea, and creatinine levels were normal while fasting sugar was
150 mg/dl. The lipid profile was:
Cholesterol–310 mg/dl
HDL cholesterol–32 mg/dl
LDL cholesterol–220 mg/dl
Triglyceride–310 mg/dl
Comment on report.Ans: The person has uncontrolled diabetes mellitus. His liver and kidney appear
to be normal as reflected by normal AST, ALT, urea, and creatinine levels.
However, serum cholesterol and LDL cholesterol levels as well as triglycer-
ide levels are high indicating hyperlipidemia. In diabetes, increased lipolysis
due to low insulin and high glucagon levels leads to excessive acetyl CoA
production which is diverted for cholesterol and triglyceride synthesis.
39.8 Case Studies of Cardiac Functions 167