Project 1: A Tale of Blood Chemistry and Health

Introduction This project is based on a similar project in your textbook. For this project, you will work in small groups to analyze data from blood test results in order to provide recommendations and an explanation ofa patient's current medical condition. Below you will find a description of the scenario you will be addressing, as well as the results from the described patient's blood test. After reading through the scenario and data, you will produce a nal report in two parts with your group. Background Abby Tudor recently turned 40 years old. Her knees ache, and she often feels short of breath during exercise. She is experiencing fatigue and often feels that she is going in slow motion. Periodic dizziness plagues her during most days. According to the drugstore machine, her blood pressure is elevated. Her family has a history of cardiac disease, with both of her parents having experienced heart attacks. Additionally, an au nt on her mother's side has diabetes. Hypothyroidism also runs throughout her immediate family.Abby is approximately 20 pounds overweight. She has tried various diet and exercise programs in an attempt to lose weight. Her results have been disappointing. With the advice of her physician, she scheduled an appointment for a full physical exam, including a complete blood workup. Her doctor is particularly interested in the level of various blood components that might shed some light on Abby's reported symptoms. Specically, he wants to examine her white blood cell count, red blood cell count, hemoglobin, and hematocrit gures for indications of infection or anemia. Her serum glucose level will provide information concerning the possibility of the onset of diabetes. Cholesterol and triglyceride levels will provide insight into potential cardiac problems. Additionally, the possibility of hypothyroidism will be investigated by examining Abby's serum TSH level. As instructed, two weeks before her doctor's appointment, she reported to her doctor's lab for a blood test. She conrmed for the lab technician that she had fasted for the 12 hours immediately preceding the exam. Du ring her physica|,Abby's doctor went over the blood test report with her. He expressed concern over some of the results, but Abby was not convinced that she had a problem. Additional blood tests were not a viable option because it takes a good deal of time to get a sample of readings a nd they are expensive. At the time of her doctor's appointment, she was unwilling to accept the offered prescriptions. She chose to do a little research before committing herself to any drug regimen. Her research revealed that many medical measurements, such as cholesterol, are normally distributed in healthy populations. Unfortunately, the lab report did not provide the means and standard deviations necessaryfor Abby to calculate the various probabilities of interest. However, the report did provide the appropriate reference intervals. Assuming that the reference intervals represent the range of values for each blood component for a healthy adult population, it is possible to estimate the various means and standard deviations for this population. Abby estimated each mean by taking the midpoint of its reference interval. Using the Range Rule of Thumb, standard deviations were estimated by dividing the reference interval range by 4. The following table lists Abby's blood test results, as well as the mean and standard deviation for a number of blood test components for the population of normal healthy adults. Before beginning any analysis of Abby's results, make sure you understand how the standard mean and deviation score were estimated. You can do this by checking the calculations for the HDL cholesterol test. The reference interval for HDL cholesterol is 35 to 150 mg/dL. Use this information to confirm the mean and standard deviation that Abby estimated for this blood component. Blood Test Components for Healthy Adults and the Blood Test Results for Abby * Abby's Blood Test Component Unit Standard Mean Abby's Absolute Deviation Result White blood cell count 103/HL 7.5 1.25 1.5 Red blood cell count 10/UL 4.7 0.30 3.5 Hemoglobin g/dL 15.0 1.50 10.8 Hematocrit % 44.5 3.75 31.1 Glucose, serum mg/dL 79.5 9.75 95.0 Creatine, serum mg/dL 1.05 0.125 0.8 Sodium, serum mEq/L 140.5 2.25 143.0 Potassium, serum mEq/L 4.3 0.4 5.1 Chloride, serum mEq/L 102.5 2.25 100.0 Carbon dioxide, total mEq/L 26.0 1.5 25.0 Calcium, serum mg/dL 9.4 0.4 10.1 Total cholesterol mg/dL 149.5 24.75 253.0 Triglycerides mg/dL 99.5 49.75 150.0 HDL cholesterol mg/dL 92.5 28.75 42.0 LDL cholesterol mg/dL 64.5 32.25 181.0 LDL/HDL ratio Ratio 1.8 0.72 4.3 TSH, high sensitivity, serum mcIU/mL 2.925 1.2875 3.15"NOTE! Population means and standard deviations were estimated from the reference intervals derived from an actual blood test report provided by TA LabCorp, Tampa, Florida. Means were estimated by taking the midpoints of the reference intervals. Standard deviations were estimated by dividing the reference interval ranges by 4. Test results attributed to Abby Tudor are actual results obtained from an anonymous patient. For any blood component measurement that was below its population mea n, Abby decided to calculate the probability that she would get a test value equal to the value obtained or less, given that she was a member of the healthy population. For example, her HDL cholesterol reading {42 mgde] was below the mean of the healthy population (92.5 mgldL), so she calculated the following probability: Pix 5 42 micro Similarly, for any blood component measu rement reading exceeding its population mea n, Abby decided to calculate the probability that she would get a test value equal to the value obtained or more, given that she was a mem ber of the healthy population. For example, her LDL cholesterol value {181 mg/dL) exceeds the mean of the healthy population (64.5 mg/d L}, so she calculated the following probability: :3sz 181 mgfdtl To help her interpret the calculated probabilities,Abby decided to be concerned about only those blood components that had a probability of less than 0.025. By choosing this gure, she is acknowledging that it is unlikely that she could have such an extreme blood component readingand still be part of the healthy population. Part 1 For this section of the report, focus on the results that fall below the estimated mean for the population. 1. Using the estimated means and standard deviations calculate the probability of obtaining Abby's actual result for each blood component where her result falls above the standard mean. 2. Using Abby's criterion, determine which blood components should be a cause of concern for Abby. Which results exceed the criterion that she set for an "extre me" reading? 3. Write u p a summary report of your ndings. In your summary report, be sure to include a discussion concerning your assumptions and any limitations to your conclusionsAlso, using a resource such as Howr to interpret your blood test results 3' , write an explanation for Abby about at least one of her extreme ndings. Section 2 For this section of the report, focus on the results fall fell above the estimated mean for the population. 0 Using the estimated means and standard deviations calculate the probability of obtaining Abby's actual result for each blood component where her result falls above the standard mean. . Using Abby's criterion, determine which blood components should be a cause of concern for Abby. Which results exceed the criterion that she set for an "extreme" reading? . Write up a summary report of your findings. In your summary report, be sure to include a discussion concerning your assumptions and any limitations to your conclusions. Also, using a resource such as How to interpret your blood test results @ , write an explanation for Abby about at least one of her extreme findings