Doador 6439 - Medical Profile

This donor is a healthy carrier for a genetic disease.
Please see his Genetic Testing Summary and Acknowledgment of Genetic Risk for details

Personal Behavior History

Question	Response
Current alcohol use: If yes, oz./week and type of alcohol:	Occasionally - 16oz. beer/week
Tobacco use: Do you smoke? If yes, #/day and for how long:	No
If you did smoke but quit, when did you last smoke?	N/A
For how many years?	N/A
Do you sleep well?	Yes
Do you exercise on regular basis?	Yes
Is your diet well balanced? If no, explain:	Yes
Are you a vegetarian?	No
Any dietary restrictions? If yes, explain:	No

Sexual History

Question	Response
A partner whose sexual background you are unsure of in the past 12 months?	No

Donor Genetic History

Question	Response
Do you have a history of a speech disorder; such as a speech impediment, stuttering, delayed speech development, etc.? If yes, explain:	No
Do you have learning differences, such as dyslexia? If yes, explain:	No
Were you or any family members born with any birth defects? If yes, explain:	No

Donor Medical History

Question	Response
List any operations: Age & reason:	Appendectomy. Wisdom teeth extraction - 11 due to appendicitis, 25 routine procedure
Hospitalization other than surgery: Age & type of illness:	N/A - N/A
Have you ever had any broken bones? If yes, please give age and description:	No
Have you ever had any serious illnesses? If yes, please give age and description:	No
Are you presently under a physician's care for any reason? If yes, please describe:	No
List all drugs you have taken in past 12 months (prescription, nonprescription, herbal, and sports supplements, and recreational). Include drug, frequency and duration taken, and reason:	N/A - N/A; N/A; N/A
List all current medication or treatments (include vitamins, aspirin, antacids, laxatives, herbal, sports supplements, etc.) Include drug, frequency and duration taken, and reason:	Ibuprofen - Once every 2-3 Months; 1 Day; Minor Headache
Do you wear glasses or contact lenses? Are you near or far-sighted?	No
Birth weight lbs	7
Birth weight ozs	8
Recent weight loss or gain? # of lbs and reason:	No
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	No
How many sexual partners do you currently have?	1
Have you ever had a tattoo?	No
Have you ever had your ear(s) or body pierced?	No

Family Medical History
Ver lista de perguntas. here

Mother's Father Ethnic Origins	German
Mother's Mother Ethnic Origins	German
Father's Father Ethnic Origins	Norwegian
Father's Mother Ethnic Origin	Norwegian
Is anyone in your family of Ashkenazai Jewish Heritage?	No
If yes, who?	N/A

Your Mother

Question	Response
Current age or age at death	63
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Father

Question	Response
Current age or age at death	70
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Prostate cancer

Radiation, no surgery

Brothers

Your Brother 1

Question	Response
Current age or age at death	36
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Brother 2

Question	Response
Current age or age at death	26
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Mother's Father

Question	Response
Current age or age at death	87
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Heart attack

None listed, quit smoking

High blood pressure

Medication controlled

Your Mother's Mother

Question	Response
Current age or age at death	88
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Mother's Sisters 1

Question	Response
Current age or age at death	66
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Mother's Sisters 2

Question	Response
Current age or age at death	60
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Father's Father

Question	Response
Current age or age at death	96
Living / Dead	Dead
Cause of death and any treatment prior to death	Passed in sleep, respiratory failure

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Other lung disease

Respiratory failure, no treatment

Prostate cancer

Surgery

Your Father's Mother

Question	Response
Current age or age at death	87
Living / Dead	Dead
Cause of death and any treatment prior to death	Lung Cancer

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Lung cancer

Radiation

Breast cancer

Mastectomy and chemotherapy

Your Father's Brothers 1

Question	Response
Current age or age at death	72
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Kidney Stones

Passed at home

Your Father's Brothers 2

Question	Response
Current age or age at death	67
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Other heart disease

Heart surgery to replace valve

Anxiety

Medication

Depression

Medication

Drug abuse, misuse, or addiction

Recovery, relapsed at 65 and recovered again

Your Father's Brothers 3

Question	Response
Current age or age at death	60
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Número do Doador: 6439

Personal Behavior History

Sexual History

Donor Genetic History

Donor Medical History

Family Medical HistoryVer lista de perguntas. here

Family Medical History
Ver lista de perguntas. here