Donor 5100 - Summary Profile

Physical

Medical

Question	Response
Have you or any of your family members been diagnosed with alcoholism or drug addiction? If yes, relation and age affected:	No
Any dietary restrictions? If yes, explain:	No
Do you wear glasses or contact lenses? Are you near or far-sighted?	No
Allergies (medicines, food, pollens)? If yes, please list substance and reaction caused:	Yes - Seasonal pollens, cat dander: Cause itchy, watery eyes, sneezing
CMV IgG Antibody	Positive
CMV IgM Antibody	Negative
Note any comments regarding above items:	N/A

Family Medical History
See list of questions asked here

Your Mother

Question	Response	Comment/Age Affected
Current age or age at death	47
Health Problem	Healthy
Living / Dead	Living

Your Father

Question	Response	Comment/Age Affected
Current age or age at death	48
Health Problem	High blood pressure, controlled with medication	40
Health Problem	High cholesterol, controlled with medication	40
Living / Dead	Living

Brothers

Your Brother 1

Question	Response	Comment/Age Affected
Current age or age at death	21
Health Problem	Asthma, controlled with inhaler	9
Living / Dead	Living

Sisters

Your Sister 1

Question	Response	Comment/Age Affected
Current age or age at death	18
Health Problem	Healthy
Living / Dead	Living

Your Mother's Father

Question	Response	Comment/Age Affected
Current age or age at death	73
Health Problem	Testicular cancer, treated with surgery and chemotherapy	59
	Testicular cancer, no treatment	73
	Cause of death: Testicular cancer	73
Living / Dead	Dead

Your Mother's Mother

Question	Response	Comment/Age Affected
Current age or age at death	84
Health Problem	Diabetes mellitus requiring insulin therapy	65
Living / Dead	Living

Your Mother's Sisters 1

Question	Response	Comment/Age Affected
Current age or age at death	65
Health Problem	Healthy
Living / Dead	Living

Your Mother's Sisters 2

Question	Response	Comment/Age Affected
Current age or age at death	52
Health Problem	Healthy
Living / Dead	Living

Your Mother's Sisters 3

Question	Response	Comment/Age Affected
Current age or age at death	41
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	63
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 2

Question	Response	Comment/Age Affected
Current age or age at death	54
Health Problem	Healthy
Living / Dead	Living

Your Mother's Brothers 3

Question	Response	Comment/Age Affected
Current age or age at death	49
Health Problem	Healthy
Living / Dead	Living

Your Father's Father

Question	Response	Comment/Age Affected
Current age or age at death	68
Health Problem	Prostate cancer, treated with chemotherapy	68
Living / Dead	Living

Your Father's Mother

Question	Response	Comment/Age Affected
Current age or age at death	69
Health Problem	High blood pressure, controlled with medication	45
Health Problem	High cholesterol, controlled with medication	45
Living / Dead	Living

Your Father's Brothers 1

Question	Response	Comment/Age Affected
Current age or age at death	49
Health Problem	Healthy
Living / Dead	Living

Height: 5'10" (177 cm)	Weight: 188 lb (85 kg)	Eye Color: Brown	Hair: Brown/ Straight	Skin Tone: Light	Ancestry: Caucasian
	Blood Type: A+	Ethnic Background: French-German/German-Russian
	Education: BA/Political Science		Occupation: Project Manager
Interests:	Football, Horses, Movies, Wrestling

Faith	Christian
Denomination	Catholic

Update Available	Yes
Updates - Personal	N/A
Updates - Medical	Donor's CMV status is updated to IgG Antibody positive in September 2017. CMV IgM Antibody remains negative.
Updates - Family Medical History	N/A

Donor Number: 5100

Physical

Medical

Family Medical History
See list of questions asked here

Religion:

Updates to Profile

Donor Number: 5100

Physical

Medical

Family Medical HistorySee list of questions asked here

Religion:

Updates to Profile

Family Medical History
See list of questions asked here