Specimen Name Result Units Range
Plasma Sodium 133 mmol/L (135-145)
Potassium 3.3 mmol/L (3.5-5.5)
Chloride 105 mmol/L (100-109)
Bicarbonate 23 mmol/L (22-32)
Anion Gap 8 mmol/L (7-17)
Glucose 6.5 mmol/L (3.8-5.5)
Urea 5.3 mmol/L (2.7-7.2)
Creatinine 60 μmol/L (60-110)
Osmolality 264 mmol/kg (275-295)
Urate 0.22 mmol/L (0.20-0.40)
Phosphate 0.69 mmol/L (0.80-1.45)
Total Calcium 2.25 mmol/L (2.10-2.55)
Ionized Calcium 1.35 mmol/L (1.07-1.27)
Albumin 27 g/L (34-48)
Globulins 19 g/L (22-35)
Total Bilirubin 94 μmol/L (6-24)
GGT 682 U/L (< 60)
ALP 366 U/L (30-110)
ALT 100 U/L (< 55)
AST 114 U/L (< 45)
LDH 219 U/L (110-230)
CK 254 U/L (< 200)

71yo disheveled male - admitted post cardiac arrest.
Chronic Alcoholic - Post-Arrest
  • mixed hyperbilirubinaemia
  • disproportionate rise in GGT : AST/ALT
  • mild hypo-osmolar hyponatraemia
  • hypoalbuminaemia

NB:

  • low AG and normal HCO3-:
    • ∴ no significant lactic acidosis
    • unusual given ETOH history & ↑risk ∝ malnutrition/thiamine-deficiency
  • negative osmolar gap
    • measured osmo < calculated (≈ 275 mmol/kg)
    • most likely measurement error

 

Alcoholic Liver Disease

  1. Hepatitis
    • AST:ALT ratio > 2.0
    • greater rise in GGT
    • hyperbilirubinaemia
  2. Cirrhosis
    • hyperbilirubinaemia
    • mild elevation of AST > ALT
    • hypoalbuminaemia & hyperglobulinaemia
    • ↑ APTT/INR
    • low Na+, K+, Mg++ (dilution & 2° hyperaldosteronism)
    • low urea, Ca++
    • high NH3 & glucose
    • ABGs : compensated respiratory alkalosis