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Specimen
Name
Result
Units
Range
Plasma
Sodium
157
mmol/L
(135-145)
Potassium
4.8
mmol/L
(3.5-5.5)
Chloride
126
mmol/L
(100-109)
Bicarbonate
26
mmol/L
(22-32)
Anion Gap
10
mmol/L
(7-17)
Glucose
5.4
mmol/L
(3.8-5.5)
Urea
4.1
mmol/L
(2.7-7.2)
Creatinine
100
μmol/L
(60-110)
Osmolality
322
mmol/kg
(275-295)
Urine
Sodium
75
mmol/L
(> 20)
Osmolality
678
mmol/kg
33yo female.
Longstanding psych. issues, with multiple admissions ∝ O/D
Analysis
Exogenous NaCl Ingestion
hypernatraemia usually seen with uraemia ∝ hypovolaemia
normal urea suggests normovolaemia
∴ possible causes:
IVT with hypertonic NaCL
IVT with N-saline & ongoing H
2
O losses
drugs with high salt load - NaHCO
3
, ABx (beta-lactams)
mineralocorticoid excess → usually with hypokalaemic alkalosis
** unlikely as urinary [Na
+
] would be low
TPN