Specimen Name Result Units Range
Plasma Sodium 142 mmol/L (135-145)
Potassium 4.3 mmol/L (3.5-5.5)
Chloride 99 mmol/L (100-109)
Bicarbonate 32 mmol/L (22-32)
Anion Gap 15 mmol/L (7-17)
Glucose 7.2 mmol/L (3.8-5.5)
Urea 7.4 mmol/L (2.7-7.2)
Creatinine 120 μmol/L (60-110)
Osmolality 281 mmol/kg (275-295)
Urate 0.50 mmol/L (0.20-0.40)
Phosphate 1.33 mmol/L (0.80-1.45)
Total Calcium 3.14 mmol/L (2.10-2.55)
Albumin 34 g/L (34-48)
Globulins 25 g/L (22-35)
Total Bilirubin 5 μmol/L (6-24)
Conj. Bilirubin 3 μmol/L (1-4)
GGT 7 U/L (< 60)
ALP 96 U/L (30-110)
AST 26 U/L (< 45)
LDH 1,160 U/L (110-230)
Cholesterol 5.8 mmol/L (3.5-5.5)

75yo female known to haematology unit.
Hypercalcaemia
  • likely malignancy-related given history
  • hyper-parathyroidism but PO4 is too high

Parathyroid hormone:

  • ↑ movement of Ca++ & PO4 out of bone
  • ↑ renal tubular reabsorption of Ca++
  • ↓ renal tubular reabsorption of PO4
  • ↑ Vit.D3 → indirect effects:
    • ↓ H+ secretion / HCO3- reabsorption in PT
    • ↓ plasma pH → displaces Ca++ from plasma protein & bone
    • ↑ renal PO4 excretion → ↓[Ca++].[PO4] product
      → facilitating further bone reabsorption

Hyper-parathyroidism causes:

  • hypercalcaemia with low-normal PO4
  • bone reabsorption with cystic changes
  • ectopic calcification
  • renal stones
  • overall rise in renal Ca++ excretion ∝ filtered mass