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?