(Solved): Mrs. Giammo is a 59-year-old woman who was brought to the emergency department. by her husband. Mr. ...

Mrs. Giammo is a 59-year-old woman who was brought to the emergency department. by her husband. Mr. Giammo noticed that suddenly, his wife "was slurring her speech and her face was drooping on one side." Mrs. Giammo told her husband that she felt some numbness on the right side of her face and in her right arm. Mr. Giammo was afraid his wife was having a stroke, so he brought her to the hospital. Case Study In the emergency department, Mrs. Giammo is alert and oriented. Her vital signs are temperature \( 98.28 \mathrm{~F}(36.78 \mathrm{C}) \), blood pressure \( 148 / 97 \), pulse 81 , and respiratory rate 14. Mrs Giammo has a history of Rheumatoid Arthritis and GERD. She is \( 5^{\prime} 4^{\prime \prime} \) tall and weighs 175 lbs. She had her gall bladder out 15 years ago. She has never smoked but enjoys a glass of wine with dinner. Mrs. Giammo is still complaining of "numbness" of the right side of her face and down her right arm. Her mouth is noted to divert to the right side with a slight facial droop when she smiles. Her speech is clear. She can move all her extremities and follow commands. Her pupils are round, equal, and reactive to light ( \( 4 \mathrm{~mm} \) to \( 2 \mathrm{~mm} \) ) and accommodation. There is no nystagmus noted. Her right-hand grasp is weaker than her left. Mrs. Giammo does not have a headache and denies any nausea, vomiting, chest pain, diaphoresis, or visual complaints. She is not experiencing any significant weakness, has a steady gait, and is able to swallow without difficulty. Diagnostic Tests A head computed tomography (CT) scan is done which shows no acute intracranial change and a magnetic resonance imagery (MRI) is within normal limits. An electrocardiogram (ECG, EKG) monitor shows a normal sinus rhythm. An electrocardiogram (ECG, EKG) monitor shows a normal sinus rhythm. Laboratory blood test results are as follows: White blood cell (WBC) 8,000 cells/mm \( { }^{3} \), sodium \( \left(\mathrm{Na}^{2}+149 \mathrm{mEq} / \mathrm{L}\right. \) hemoglobin (Hgb) \( 14 \mathrm{~g} / \mathrm{dL} \), potassium \( \left(\mathrm{K}^{+}\right) 4.5 \mathrm{mEq} / \mathrm{L} \), hematocrit (Hct) \( 44 \% \), platelets \( =294,000 \) glucose \( 105 \mathrm{mg} / \mathrm{dL} \), \( \mathrm{mm}^{3} \), calcium \( \left(\mathrm{Ca}^{2+}\right) 9.5 \mathrm{mg} / \mathrm{dL} \), erythrocyte sedimentation rate (ESR) 15 blood urea nitrogen (BUN) \( 15 \mathrm{mg} / \mathrm{dL} \), and \( \mathrm{mm} / \mathrm{hr} \), creatinine (creat) \( 0.8 \mathrm{mg} / \mathrm{dL} \). prothrombin time (PT) \( 12.9 \) seconds, international normalized ratio (INR) 1.10, Mrs. Giammo is scheduled for admission to have a neurology evaluation, magnetic resonance angiography (MRA) of the brain, a fasting serum cholesterol, and blood pressure monitoring. Mrs. Giammo needs to have her fasting cholesterol levels checked. How long must Mrs. Giammo fast before the test? Mrs. Giammo's cholesterol lab work reveals the following: total cholesterol \( 242 \mathrm{mg} / \mathrm{dL} \), low-density lipoprotein (LDL) \( 165 \mathrm{mg} / \mathrm{dL} \), high-density lipoprotein (HDL) \( 30 \mathrm{mg} / \mathrm{dL} \). Discuss the normal values of each and which of her results are of concern and why.