Question

1. Mrs. Jones, a 40-year-old female patient, is presenting for a history and physical. The nurse gathers a family history from the patient. She shares that her mother died at 70 years of age of colon cancer and had adult onset diabetes controlled with oral agents, hypercholesterolemia, and hypertension. She had a stroke before passing away. Her father died at 67 years of age from a stroke. He had a long history of alcoholism and smoked two packs per day of cigarettes for 50 years. He had acks; the first heart attack was at 30 years of age and the second at 52 years of age. He had adult onset diabetes controlled with oral agents since 50 years of age. He had renal stenosis that was unsuccessfully treated with a renal angioplasty and he developed end-stage renal failure requiring hemodialysis. Mrs. Jones has two brothers. One brother developed hypertension, hypercholesterolemia, and adult onset diabetes controlled with oral agents at 50 years of age. The second brother has no health problems. The maternal grandmother died at 88 years of age of a stroke and had hypertension. The maternal grandfather died at 70 years of age of a massive heart attack and had a history of hypertension. The paternal grandmother died at 80 years of age of a heart attack. The paternal grandfather died at 50 years of age from bleeding esophageal varices related to long-standing alcoholism. The patient shares that her mother's first cousin, George, died at 52 years of age of Hodgkin lymphoma. She has another first cousin Mabel, 72 years of age, who is alive but has had cancer of the colon and had a recent stroke, and has a history of hypertension, hypercholesterolemia, and adult onset diabetes controlled with diet. Her mother's sister, who is 68 years of age, is alive and has a history of hypertension and hypercholesterolemia. Her mother's brother died at 68 years of age of renal cancer and had a history of hypertension, hypercholesterolemia, and adult onset diabetes controlled with oral agents. He also had a heart attack at 45 years of age and a coronary artery bypass graft operation of three vessels at 55 years of age. He smoked cigarettes for 50 years. The patient's father was an only child and her father's family all lived to be over 80 years of age. a. What genetic related diseases do the patient's first-order relatives have? b. What genetic related diseases do the patient's second-order relatives have? c. Optional: Draw a genogram of the patient's family's health history using the example in the textbook (see Fig. 5-2) as a guide.

Answer 1

a. Genetic-related diseases in first-order relatives:

• The patient's first-order relatives are her mother, father, and her brother.
• These members have genetically related disease of hypertension, hypercholesterolemia, diabetes.
• The patient mother had a history of cancer.
• The patient father had a history of two heart attacks.

b. Genetic-related diseases in second-order relatives:

• The patient's second-order relatives are grandparents, mother's brothers(George and Mabel), and Mother's sister.
• The maternal grandfather and grandmother had a history of hypertension.
• Her maternal grandfather and paternal grandmother had a history of heart attacks.
• The patient mother's brother and sister have a history of cancer.
• Her maternal grandmother and her mother's brother Mabel had a history of stroke.
• Her mother's brother Mabel had a genetically related disease of stroke.