Specimen Name Result Units Range
Plasma Sodium 139 mmol/L (135-145)
Potassium 2.8 mmol/L (3.5-5.5)
Chloride 113 mmol/L (100-109)
Bicarbonate 19 mmol/L (22-32)
Anion Gap 10 mmol/L (7-17)
Glucose 4.9 mmol/L (3.8-5.5)
Urea 2.7 mmol/L (2.7-7.2)
Creatinine 60 μmol/L (60-110)
Osmolality 270 mmol/kg (275-295)
Urate 0.17 mmol/L (0.20-0.40)
Phosphate 1.09 mmol/L (0.80-1.45)
Total Calcium 2.03 mmol/L (2.10-2.55)
Albumin 21 g/L (34-48)
Globulins 58 g/L (22-35)
Total Bilirubin 221 μmol/L (6-24)
Conj. Bilirubin 85 μmol/L (1-4)
GGT 176 U/L (< 60)
ALP 667 U/L (30-110)
AST 87 U/L (< 45)
LDH 94 U/L (110-230)
Cholesterol 7.6 mmol/L (3.5-5.5)

52yo female with history of ETOH abuse.
Metabolic Acidosis - Normal AG
  • hyperchloraemia / normal-AG metabolic acidosis
  • significant hypokalaemia
    → in the setting of acidosis ≅ marked whole body deficit
  • obstructive jaundice : ? ETOH / cirrhosis

 

Hyperchloraemia may result from:

  1. Any hypernatraemic state
  2. Respiratory alkalosis
  3. Metabolic acidosis + normal AG:
    • renal
    • RTA
    • CA inhibitors
    • early uraemia
    • extra-renal
    • diarrhoea
    • hypoadrenalism
    • uretero-sigmoidoscopy
    • treated DKA
    • exogenous HCl

 

Hyperbilirubinaemia predominantly Conjugated

  • Biliary obstruction
    • biliary cirrhosis - primary | secondary
    • sclerosing cholangitis
    • extrahepatic obstruction - stone, tumour, stricture
  • Impaired hepatic excretion
    • sepsis
    • post-operative state
    • hepatocellular disease
      • hepatitis - viral, ischaemic, drug-induced
      • cirrhosis
    • drug-induced cholestasis - OCP, methyltestosterone
    • inherited disorders:
      • Dubin-Johnson
      • Rotor syndrome
      • benign familial cholestasis
    • cholestasis of pregnancy