  1. Mr. dela Cruz is a 65-year-old male weighing 250 lbs, standing 5'5" tall. He experienced an episode of body weakness 3 days prior to consultation. Upon initial evaluation of the attending physician, he noted that his appetite has increased, as well as his water intake due to excessive thirst, and an increased urine output. What do you think is the clinical diagnosis of the patient? What tests should be performed to confirm your diagnosis?
What caused the increase in water in take as well as an increased urine output? 2. Mrs. Evangelista is a 43-year-old female, married to an active seaman with two children. 2 weeks prior to admission, the patient experienced episodes of body weakness with a bloated feeling. Slight discoloration of the skin was evident 1 day prior to consultation ultrasound of the biliary tree and Blood bilirubin level was requested. Ultrasound reveals a slight unidentified mass on the gall bladder presumptive of a stone. Laboratory examination reveals a high total bilirubin, normal indirect bilirubin and an increased direct bilirubin.
Urine urobilinogen is decreased. What is the reason why the total bilirubin is increased? What caused the increased direct bilirubin? What caused the normal indirect bilirubin?
What do you think is the clinical diagnosis of the patient?
Was the ultrasound report correlate with the clinical signs and symptoms presented as well as the laboratory results? 3. Mr. San Pedro is a 78-year-old male working as a priest. His annual physical examination reveals and increased acid phosphatase.
Upon consultation, the attending physician requested for his PSA level. Noting that the PSA level is increased, what is the correlation of the acid phosphatase with the PSA level? What clinical condition is presented here? 4. A 35 year old male was suffering from difficulty in urinating with slight pain in the lower back. Upon consultation, the physician requested for his serum BUN and Creatinine. Laboratory results reveal an increased BUN and creatinine. The creatinine level is twice the upper limit. Knowing this, the doctor requested for a 24 hour urine creatinine clearance. The result of the creatinine clearance is low. What do you think is the reason for the low creatinine clearance as correlated with the high serum creatinine level. What is the purpose of performing creatinine clearance for a nephro-patient 
