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Case Studies
Case Study 3: A young healthy woman with a positive family history.
Claire is a 36-year-old Irish-American female with no health-related
complaints. Her brother was recently diagnosed with hemochromatosis. After
talking with him and researching hemochromatosis on the Internet, she
decided to make an appointment for a routine physical exam and discuss her
health concerns with her primary care provider. Past Medical History:
- No significant past medical history.
- Two normal pregnancies; two healthy preschool-aged children.
- Uses oral contraceptives.
- Denies routine blood donation.
Family History:
- Father alive and healthy at age 67.
- Mother alive with arthritis at age 63.
- Brother age 42 has "heart problems" and was recently diagnosed with
hemochromatosis. Genetic testing results: homozygote (C282Y/C282Y).
- Sister age 38 alive and apparently healthy. Genetic testing results:
heterozygote (C282Y/normal).
- Sister age 34 alive and apparently healthy.
Social History:
- Denies tobacco use, denies alcohol consumption, denies recreational
drug use.
- States she eats a "healthy diet," including 6–8 servings of fruits
and vegetables a day; avoids eating red meat.
- Denies multivitamin use.
Physical Exam:
- Normal.
- Height: 5'5" Weight: 135 lbs.
- Vital signs within normal limits.
After reviewing Claire’s medical record, please respond to the
questions below with your best possible answers. Response formats for
responding vary within the case study. Some questions will be open-ended,
requiring you to compare your response to the expert opinion. Other
questions will be multiple choice or drop-down choices.
As you counsel Claire, she states that she is not willing to undergo
genetic testing due to a recent job change and a concern that she may be
denied medical insurance.
Summary of Case Study
- A patient with genetic predisposition for hereditary hemochromatosis
needs biochemical testing to check for iron overloading.
- The known family history helps with the evaluation.
- Biochemical measures can confirm the absence of iron overload.
- Patient should be re-evaluated for iron overloading in 2–5 years.
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