Na+ |
149 |
135-145 mmol/L |
K+ |
4.5 |
3.5-5.0 mmol/L |
Cl- |
109 |
100-109 mmol/L |
HCO3- |
24 |
22-33 mmol/L |
Urea |
40 |
2.7-8.0 mmol/L |
Creatinine |
140 |
50-120 micromol/L |
Ca++ |
2.3 |
2.1-2.6 mmol/L |
PO4- |
1.4 |
0.8-1.45 mmol/L |
Albumin |
34 |
33-50 mmol/L |
Gluc |
6.5 |
3.0-7.8 mmol/L |
A) List 3 differential diagnoses of the above plasma biochemistry ?
College Answer
A) Dehydration
B) GIT bleed
C) Steroid therapy
Discussion
This question is almost identical to Question 6.3 from the second paper of 2012. In this version, the college increased the urea to 40mmol/L, and asked for only three differentials. Differentials listed in the chapter concerned with uraemia are reproduced below to simplify revision.
Increased exogenous urea
Decreased urea clearance Increased renal reabsorption of urea
Decreased renal clearance of urea
|
Increased urea synthesis Increased protein intake
Increased protein catabolism
|