A female patient of 25 years old is recovering in the post-operative care unit in the hospital. Her blood biochemistry results are: Analyte (SERUM)ResultReference intervalSodium131135 – 145 mmol/LPotassium5.03.5 – 5.5 mmol/LChloride11295 – 110 mmol/LBicarbonate2922 – 32 mmol/LFasting glucose3.83.6 – 5.5 mmol/Lcalcium2.22.15 – 2.55 mmol/LLactate25< 3.0 mmol/LHow would you explain the abnormal results?Group of answer choicesArtefact due to Hartmann’s solution intravenous fluidArtefact due to 5% dextrose intravenous fluidHypoglycaemiaMetabolic acidosis
Question
A female patient of 25 years old is recovering in the post-operative care unit in the hospital. Her blood biochemistry results are: Analyte (SERUM)ResultReference intervalSodium131135 – 145 mmol/LPotassium5.03.5 – 5.5 mmol/LChloride11295 – 110 mmol/LBicarbonate2922 – 32 mmol/LFasting glucose3.83.6 – 5.5 mmol/Lcalcium2.22.15 – 2.55 mmol/LLactate25< 3.0 mmol/LHow would you explain the abnormal results?Group of answer choicesArtefact due to Hartmann’s solution intravenous fluidArtefact due to 5% dextrose intravenous fluidHypoglycaemiaMetabolic acidosis
Solution 1
The patient's blood biochemistry results show three abnormal values: Sodium, Chloride, and Lactate.
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Sodium: The patient's sodium level is 131 mmol/L, which is below the reference interval of 135 – 145 mmol/L. This condition is known as hyponatremia. It can be caused by a variety of conditions, including certain medications, kidney or heart problems, and dehydration.
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Chloride: The patient's chloride level is 112 mmol/L, which is above the reference interval of 95 – 110 mmol/L. This condition is known as hyperchloremia. It can be caused by conditions such as kidney disease, excessive intake of dietary salt, or dehydration.
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Lactate: The patient's lactate level is 25 mmol/L, which is significantly above the reference value of less than 3.0 mmol/L. High lactate levels can indicate lactic acidosis, a form of metabolic acidosis, which can be caused by conditions such as prolonged exercise, heart failure, sepsis, or shock.
Given these results, the most likely explanation for the abnormal results is metabolic acidosis. This is supported by the high lactate levels, which indicate a buildup of acid in the body. The hyponatremia and hyperchloremia could be related to this condition, as metabolic acidosis can affect the body's balance of electrolytes. However, further tests would be needed to confirm this diagnosis and identify the underlying cause.
Solution 2
The patient's blood biochemistry results show three abnormal values: Sodium, Chloride, and Lactate.
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Sodium: The patient's sodium level is 131 mmol/L, which is below the reference interval of 135 – 145 mmol/L. This indicates hyponatremia, which could be due to various reasons such as excessive fluid intake, kidney disease, or certain medications.
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Chloride: The chloride level is 112 mmol/L, which is slightly above the reference interval of 95 – 110 mmol/L. This could indicate hyperchloremia, which could be due to dehydration, kidney disease, or excessive intake of salt.
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Lactate: The lactate level is 25 mmol/L, which is significantly above the reference interval of less than 3.0 mmol/L. This could indicate lactic acidosis, a condition characterized by a buildup of lactate in the body, which can result from intense exercise, severe dehydration, or certain medical conditions such as heart failure or sepsis.
Given these results, the most likely explanation for the abnormal results is metabolic acidosis, which is a condition that occurs when the body produces too much acid or when the kidneys are not removing enough acid from the body. This could explain the high lactate and chloride levels and the low sodium level. However, further tests would be needed to confirm this diagnosis.
Similar Questions
A 48-year-old man felt drowsy. He was alone at home on a warm Australia Day long weekend. He collapsed in the backyard and was fortunately discovered by his son later. He was sent to the Emergency department. His blood biochemical results are:Analyte (SERUM)ResultReference intervalSodium158135 – 145 mmol/LPotassium5.53.5 – 5.5 mmol/LChloride11895 – 110 mmol/LBicarbonate2922 – 32 mmol/LFasting glucose3.83.6 – 5.5 mmol/L* Note: Urine osmolality is normalWhat is the likely reason explaining his high sodium result?Group of answer choicesExcessive loss of body fluidDiabetes insipidusOsmotic diuresis due to diabetes mellitusAddison’s disease
A 36-year-old man presents with the following blood biochemistry results:Analyte (SERUM)ResultReference intervalSodium146135 – 145 mmol/LPotassium6.83.5 – 5.5 mmol/LChloride10895 – 110 mmol/LBicarbonate2222 – 32 mmol/LUrea36.63.0 – 8.0 mmol/LCreatinine37740 – 90 μmol/LeGFR50> 90 ml/min/1.73m2Considering the abnormal results, what is the likely diagnosis for this patient?Group of answer choicesHe has acute kidney diseaseHe is on thiazide diureticsHe has metabolic acidosisHe has chronic diarrhea
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A 30-year-old man was administered in the Accident and Emergency (A&E) department of a metropolitan hospital. He appeared partially conscious and extremely weak. His biochemical blood results are:Analyte (SERUM)ResultReference intervalSodium121135 – 145 mmol/LPotassium5.63.5 – 5.5 mmol/LChloride8695 – 110 mmol/LBicarbonate1922 – 32 mmol/LUrea10.93.0 – 8.0 mmol/LCreatinine9840 – 90 μmol/LSerum osmolality340275 – 295 mOsm/kgWhat could have explained his altered serum electrolytes and osmolality?Group of answer choicesHe has acute kidney injury (AKI)Uncontrolled hyperglycaemiaHe has Conn’s syndromeHe has chronic kidney injury (CKD)
A 16-year-old male athlete was admitted to the Emergency due to fluid loss. His blood biochemistry results were:Analyte (SERUM)ResultReference intervalSodium158135 – 145 mmol/LPotassium6.03.5 – 5.5 mmol/LChloride12095 – 110 mmol/LBicarbonate1422 – 32 mmol/LUrea263.0 – 8.0 mmol/LCreatinine14240 – 90 μmol/LCreatinine kinase857< 250 IU/LLactate20.1< 3.0 mmol/LLactate was elevated by ~7-fold. What is the likely cause of this? Group of answer choicesAnaerobic metabolismArtefact due to dextrose-saline intravenous fluidArtefact due to 5% dextrose intravenous fluidArtefact due to 0.9% NaCl intravenous fluid
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