PHA311 Clinical Biochemistry Assessment

Clinical Notes:

72-Year-old Male patient.

Brought in by ambulance this evening. Patient’s wife called 000 as Mr. Smith began deteriorating throughout the week, however developed intermittent stages of confusion throughout today.

Symptoms:

Acute complaints of the patient are vomiting, fatigue, mild systemic pruritis and nocturia.

Past Medical History:

Patient has a previous history of Type 2 Diabetes Mellitus and Hypertension.

Medications:

Regular medications for the patient include Metformin 500mg and Hydrochlorothiazide 25mg. Tests requested include UEC, CMP, CRP, CK, FBC.

Provisional Diagnosis: Chronic Kidney Disease

Questions:

1. Discuss the Biochemistry and Haematology profile. What is out of range and what pathophysiological effects can the variant parameters have?

2. Haematology and Biochemistry testing are typically conducted at the same time. Quite often biochemical abnormalities can impact haematology results. Is this possible in this case? 3. Comparing the patient case notes, is there any correlation between the two profiles and the patient’s symptoms?

4. Would you consider the provisional diagnosis to be correct? What other conditions could be considered as part of a differential diagnosis?

5. Considering the patient’s past medical history, could there be a causative correlation between the history and provisional diagnosis?

6. Are there any other tests that can be performed to assist in the confirmation of the provisional diagnosis and/or rule out any other differential conditions?