Adventist University of the Philippines

Medical Laboratory Science Department

Medical Technology Assessment Program with
Clinical Correlations 1
Name: Eddrei Paullynne D. Desoasido

CASE STUDY ANALYSIS WITH CLINICAL CORRELATION

Title of Episode: The Socratic Method (Season 1, Episode 6)

Case Episode Answers:

1. What are the presenting signs and symptoms of the 38-year-old mother that was
introduced to the hospital?
- Unconsciousness, Jerky movement, Leg pain, Paranoia
2. What is the admitting diagnosis of the mother?
- Deep vein thrombosis (DVT)
3. What were the laboratory tests that aid in the in the diagnosis?
- PT, APTT, Factor V, Protein C and S (Coagulation tests)
4. How does the laboratory tests correlate with the diagnosis?
- All coagulation tests were normal except for prolonged PT which suggests Vitamin K
deficiency. Without vitamin K, protein C does not work, and without protein C, clot
happens. However, the patient was bleeding therefore ultrasound of the liver was
ordered.
5. Is there an additional manifestation of signs and symptoms when the mother is admitted?
Enumerate.
- Hematemesis, Liver tumor, Cataracts, Kayser-Fleischer rings
6. What is the final diagnosis for the case?
- Wilson’s Disease

Referral Answers:
A. What causes Wilson’s Disease?
- A hereditary ATP7B gene deficiency leads to Wilson disease. This condition is
autosomal recessive. This implies that the child must inherit the same defective gene
from both parents. Parents who simply have one faulty gene frequently don't exhibit
any symptoms of the disease but are nonetheless carriers.
B. What are its other symptoms aside from the Kayser-Fleischer rings?
- Presenting clinical features of Wilson disease include nonspecific liver disease,
neurologic abnormalities, psychiatric illness, hemolytic anemia, renal tubular Fanconi
syndrome, and various skeletal abnormalities.
C. What protein analyte should be tested to help in the diagnosis of the said disease and
what would be its result?
- Ceruloplasmin---decreased
D. What other situations is that specific protein increased and decreased? Enumerate.
- Ceruloplasmin may be higher during pregnancy, estrogen therapy, also in diseases
such as leukemia and Hodgkin lymphoma. On the other hand, it may be decreased
with patients having copper deficiency, kidney disease and Menkes disease.
 Adventist University of the Philippines
Medical Laboratory Science Department
Medical Technology Assessment Program with
Clinical Correlations 1

E. If you were Dr. House or one of the residents, what other things you would have done or
tests you would have ordered to diagnose the patient?
- Monitoring of the liver function and check the level of a protein that binds copper in
the blood (ceruloplasmin) and the level of copper in the blood.

Bonus
Write the inconsistencies you have found in this episode. Write as many as you can.
a. The legality of the son was not thoroughly identified. And once it was known to
Dr. house that he was minor, he should’ve reported it.
b. Shrinking of the tumor using ethanol was a fraudulent act.