Specimen Name Result Units Range
Plasma Sodium 137 mmol/L (135-145)
Potassium 4.4 mmol/L (3.5-5.5)
Chloride 96 mmol/L (100-109)
Bicarbonate 29 mmol/L (22-32)
Anion Gap 16 mmol/L (7-17)
Glucose 5.2 mmol/L (3.8-5.5)
Urea 5.0 mmol/L (2.7-7.2)
Creatinine 100 μmol/L (60-110)
Phosphate 1.05 mmol/L (0.80-1.45)
Total Calcium 2.26 mmol/L (2.10-2.55)
Albumin 37 g/L (34-48)
Total Protein 68 g/L (60-80)
Total Bilirubin 200 μmol/L (6-24)
GGT 65 U/L (< 60)
ALP 150 U/L (30-110)
ALT 1,050 U/L (< 55)
AST 900 U/L (< 45)

25yo male with fever, malaise and anorexia.
Acute Viral Hepatitis
  • ↑AST:ALT with ratio < 1.0 (N:1.5-2)
    • mild : <200 U/L
    • mod. : <1000 U/L
    • severe : >1000 U/L
    • ** falling levels → improvement or massive necrosis
  • ↑ALP < 2-3x
  • conjugated hyperbilirubinaemia
  • normal or mildly raised globulins
  • ± hypoalbuminaemia
  • ± hypoglycaemia
  • ↑INR

 

Hepatitis

  1. infective
    • Hepatitis - A, B, C, D, E
      • {A,E} → faecal-oral
      • {B,C,D} → blood/body-fluid
    • EBV, CMV, HSV, Coxsackie, Yellow fever
  2. metabolic
    • alcohol
    • Wilson's disease (hepatolenticular degeneration)
    • haemochromatosis
    • α1-antitrypsin deficiency
  3. autoimmune
    • chronic active hepatitis
    • drug induced
    • vasculitis, SLE, UC, PN
    • 1° biliary cirrhosis
  4. drugs
    • cholestasis
      • alcohol
      • chlorpromazine, chloramphenicol, chlorpropamide
      • tetracyclines, erythromycin, rifampicin
      • oestrogens, OCP, androgens
    • hepatitis
      • α-methyl-dopa
      • paracetamol, phenytoin, isoniazid, rifampicin
      • halothane, enflurane, & ? isoflurane
  5. toxins
    • methanol
    • vinyl chloride (H2C=CHCl), chloroform (CHCl3), CCl4
    • Amanita phalloides (mushroom)
  6. cardiovascular
    • ischaemic - hypovolaemic shock, ischaemia
    • congestive - cor pulmonale, RV failure, CCF, Budd-Chiari
  7. pregnancy - acute fatty liver of pregnancy
  8. hyperthermia