Interpretation of
Results
Dr. Esther Tsang
August 2011
Case One

Asymptomatic patient, 34/female
Hb 9.1 g/dL, WBC 7.4, platelets 455
MCV 65 fL, MCH 23 pg

What kind of anaemia is this?

Which parameters do you look at?



What are the two main differential
diagnoses?

Name 3 main investigations to send.
PBF as follows :

What are the
abnormalitie
s seen?

What are the
possible
causes for
this
diagnosis?
Case Two

40/male
Breathlessness
Hb 5.0 g/dL, Plt 125, TWC 3.9
MCV 100fL

Name three differential diagnosis?




How do you confirm your differential
diagnoses?

Some other results comes back abnormal

What is your diagnosis now?

Is there another test to support your
diagnosis?

What are the other differential diagnosis of
macrocytic anemia?
Case Three


Elderly lady with hypertension comes with
confusion.
BUSE as follows :

What are the abnormalities?

What are the possible differential diagnosis?



You decide to give him 1 pint NaCl 3% over
one hour.
The next day, his Na was 149 mmol/L.
However, he is quadriplegic and his GCS
was M3V2E2.
What do you think occurred?

What is the indication for fast correction of
Na?

What is the safe rate of correction of Na?
Case 4


25/male was admitted for generalized
weakness.
BUSE :

What is the abnormality?

You order an ECG : what do you see?

How do you correct the potassium?
Case 5


60 year old lady with DM presented with
tachypnoea.
ABG as follows :




pH 7.3
PaO2 12kPa
PaCO2 3.0kPa
HCO3 11.0 mmol/L

How do you interpret the ABG?

Why is she tachypnoeic?

What are the possible causes of metabolic
acidosis in this patient?

The renal profile is as follows :




Na 134
K 5.7
Urea 23.0
Creat 500

What are the abnormalities on the renal
profile?

How would you manage the hyperkalaemia?

What are the possible causes of renal failure
in this patient?

How will you investigate this patient?

UFEME shows






protein +++
nitrates ++
RBC++
Leu+
Ketone negative
How would you interpret the results?
Case 6


60 year old man with yellow eyes and skin
LFT






TP 65
Alb 24
Bilirubin 85
ALT 20
ALP 200
Identify the abnormalities.

How would you further investigate him?

What are the possible causes of his problem?
Case 6


28/male
Asymptomatic, health screening showed the
following :





TP 60
Alb 40
Bilirubin 5
ALT 120
ALP 40

What is the abnormality?

Name 3 possible causes :

What other investigations would you order?
Case 7



70 year old lady, admitted with fever and
bruising.
FBC Hb10, TWC 4.0, Plt 100
Coagulation profile :




PT 32s
INR 3.0
APTT 60
Identify the abnormalities.

What is the diagnosis?

What other investigations to support this
diagnosis?

What are the causes of this disorder?
Case 8



70/male with
acute
breathlessnes
s
CXR as shown
Identify the
abnormalities
Case 9



70/female with
acute
breathlessness
CXR as shown
What are the
abnormalities?
Case 10



25/male, acute
breathlessness
CXR shown
What
abnormalities?
Case 11



30/male
Cough for 4
months
What
abnormalities?