Question

What would cause the following elevations/decreases in the following lab values, given the patient's medical conditions?

PMH of polycythemia vera, metastatic prostate cancer (in remission), essential HTN, TBI, anxiety disorder

Labs:

PTT: 23.6 sec

LDL: 125 mg/dL

HbA1C: 5.9%

Answer 1

Altered PTT value is suggestive of coagulopathy.Traumatic brain injury predispose to coagulopathy.Brain is a rich source of tissue thromboplastin.This is released to the circulation in traumatic brain injury leading to activation of clotting factors ,which in turn causes depletion of coagulation proteins.This result in disseminated intravascular coagulation causing systemic coagulopathy, haemorrhage and intravascular coagulation

LDL is elevated in many patients who consume thiazide diuretics for treating hypertension.

HbA1c is in the prediabetic range.Thiazide diuretics also cause unmasking of latent diabetes. The mechanism of impaired glucose tolerance is reduced insulin secretion and impaired glucose metabolism.

New onset diabetes can also be caused by antipsychotic drugs such as clozapine used to treat anxiety