Doador 7201 - 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:	Frequently - 24 oz. beer or 4oz. vodka/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:	N/A - N/A
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:	Cannabis, Melatonin - Monthly, daily; 1 year; Recreation, sleep aid
List all current medication or treatments (include vitamins, aspirin, antacids, laxatives, herbal, sports supplements, etc.) Include drug, frequency and duration taken, and reason:	Claritin - Daily; 10 years; Allergy medication
Do you wear glasses or contact lenses? Are you near or far-sighted?	Yes - Near-sighted, 20/200
Birth weight lbs	7
Birth weight ozs	1
Recent weight loss or gain? # of lbs and reason:	No
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	Yes - Slight allergy to grass/pollen, slight allergy to cat fur. Reactions include sneezing, runny nose, occasionally itchy eyes
How many sexual partners do you currently have?	0
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	German
Father's Mother Ethnic Origin	German
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	52
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	56
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Color blindness

None, red/green color blindness

Brothers

Your Brother 1

Question	Response
Current age or age at death	18
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Sisters

Your Sister 1

Question	Response
Current age or age at death	21
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	80
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Testicular Cancer

Unsure, made full recovery

Your Mother's Mother

Question	Response
Current age or age at death	81
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	56
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	54
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Mother's Sisters 3

Question	Response
Current age or age at death	50
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Mother's Brothers 1

Question	Response
Current age or age at death	34
Living / Dead	Dead
Cause of death and any treatment prior to death	Fall from building, possible homicide. Investigation inconclusive

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Drug abuse, misuse, or addiction

3 years alcohol abuse and then got clean

Your Father's Father

Question	Response
Current age or age at death	92
Living / Dead	Dead
Cause of death and any treatment prior to death	Parkinson's

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Dementia or degenerative disorders

Unsure of treatment

Parkinson's disease

Unsure of treatment

Your Father's Mother

Question	Response
Current age or age at death	84
Living / Dead	Dead
Cause of death and any treatment prior to death	Heart failure

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Other

No other diagnosed health problems at time of death

Your Father's Sisters 1

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

Saudável

Your Father's Sisters 2

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 Father's Sisters 3

Question	Response
Current age or age at death	65
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Father's Sisters 4

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 Brothers 1

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's Brothers 2

Question	Response
Current age or age at death	58
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Father's Brothers 3

Question	Response
Current age or age at death	54
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Father's Brothers 4

Question	Response
Current age or age at death	51
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Número do Doador: 7201

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