Basic Concepts in Clinical Biochemistry-A Practical Guide.7z

(Chris Devlin) #1
Glucose: 375 mg/dl
Urea: 85 mg/dl
Creatinine: 2.1 mg/dl
Sodium: 135 mmol/L
Potassium: 5.6 mmol/L
Chloride: 95 mmol/L
Urine was positive for glucose and ketone bodies. Discuss the results.

Ans: This is a case of uncontrolled diabetes mellitus with ketoacidosis. Diabetic
patients with chronic hyperglycemia may have prominent skin and soft
tissue infections.High serum glucose levels may lead to hyponatremia.
Ketosis and acidosis elevate the serum potassium levels by causing a shift
of potassium from the intracellular to the extracellularfluid. Urea and
creatinine are increased due to prerenal acute kidney injury.
Q.5. A 45-year-old woman with symptoms of loss of weight, polyphagia, poly-
dipsia, and polyuria was brought to the hospital. Her laboratory reports
depicted:


Serum glucose (Fasting)–165 mg/dl
Serum glucose (P.P.)–225 mg/dl
The urine analysis showed absence of sugar (fasting), but sugar was present
significantly in postprandial stage. Comment on report.

Ans: Fasting and postprandial blood sugar levels are increased above normal
range, while postprandial urine sugar is positive. This indicates diabetes
mellitus. Loss of weight, polyphagia, polydipsia, and polyuria are classical
symptoms of diabetes.


39.3 Case Studies of Calcium and Phosphate Impairments


Q.1. The laboratory investigation report of a 55-year-old woman’s blood sample
revealed high calcium (12.8 mg/dl) and low potassium (2.2 mg/dl) levels.
The alkaline phosphatase activity was 45 KAU. What is the probable
diagnosis?
Ans: Increased calcium and alkaline phosphatase and decrease in phosphorus are
suggestive of hyperparathyroidism.
Q.2. A child was brought to pediatric OPD. He had bowlegs, knock-knees, and
protruding abdomen and had suffered mild convulsions. The serum calcium
level was very low. What is the probable diagnosis?
Ans: Low serum calcium levels lead to soft bones which tend to bend and delay in
walking. Hypocalcemia also causes convulsions. This is a probable case of
rickets.


39.3 Case Studies of Calcium and Phosphate Impairments 159

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