Diagnosis


Based on the findings in the specialty exam results, the diagnosis is fracture of the left 
femur midshaft and fracture of the right tibia/fibula midshaft.  The other specialty exam 
results that are of significance are the increased Alkaline phosphatase, low HCT, and 
possibly the bilirubinuria and bilirubin crystalluria.  The alk phos is probably increased 
due to the injury to the bone that occurred with the fractures.  There was some blood loss 
as a result of the trauma incurred with the HBC, therefore, this would explain the low 
HCT, in addition to the increased bilirubin in the urine which would be a result of the 
increased breakdown of red blood cells from the hemorrhage.