Doador 7272 - 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:	Rarely - 7 oz, various
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:	Widsom teeth extraction - Age 27, 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:	None - 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:	None - N/A; N/A; N/A
Do you wear glasses or contact lenses? Are you near or far-sighted?	No
Birth weight lbs	7
Birth weight ozs	6
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	English
Mother's Mother Ethnic Origins	Swedish
Father's Father Ethnic Origins	Swedish
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	70
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	80
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Gallstones

Gallbladder removed

Brothers

Your Brother 1

Question	Response
Current age or age at death	55
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Diabetes mellitus not requiring insulin therapy

Diet Management

Your Brother 2

Question	Response
Current age or age at death	49
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Brother 3

Question	Response
Current age or age at death	33
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	52
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Sister 2

Question	Response
Current age or age at death	46
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Sister 3

Question	Response
Current age or age at death	44
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Sister 4

Question	Response
Current age or age at death	35
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Sons

Your Son 1

Question	Response
Current age or age at death	2
Living / Dead	Living

Problemas de Saúde

Saudável

Daughters

Your Daughter 1

Question	Response
Current age or age at death	5
Living / Dead	Living

Problemas de Saúde

Saudável

Your Mother's Father

Question	Response
Current age or age at death	90
Living / Dead	Dead
Cause of death and any treatment prior to death	Accidental Fall

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Other

No diagnosed health problems at time of death

Your Mother's Mother

Question	Response
Current age or age at death	97
Living / Dead	Dead
Cause of death and any treatment prior to death	Tuberculosis

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Other

No other diagnosed health problems at time of death

Your Mother's Sisters 1

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

Disease

Age Diagnosed

Treatment For Condition

Alzheimer's

Medication, therapy and home care

Your Mother's Sisters 2

Question	Response
Current age or age at death	77
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	70
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Saudável

Your Mother's Sisters 4

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 Brothers 1

Question	Response
Current age or age at death	75
Living / Dead	Living
Cause of death and any treatment prior to death	N/A

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Any other sight/sound/smell disorder

None (hard of hearing due to war)

Your Father's Father

Question	Response
Current age or age at death	76
Living / Dead	Dead
Cause of death and any treatment prior to death	Car Accident

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

Other

No diagnosed health problems at time of death

Your Father's Mother

Question	Response
Current age or age at death	91
Living / Dead	Dead
Cause of death and any treatment prior to death	Influenza

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

High blood pressure

Medication and diet management

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 Brothers 1

Question	Response
Current age or age at death	81
Living / Dead	Dead
Cause of death and any treatment prior to death	COVID-19

Problemas de Saúde

Disease

Age Diagnosed

Treatment For Condition

High blood pressure

Medication and lifestyle changes

Diabetes mellitus not requiring insulin therapy

Medication and lifestyle changes

Your Father's Brothers 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

Número do Doador: 7272

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