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1) 80 year old patient with fever, dispnoea, vomiting and diarrhoea since two weeks (from medscape).
Laboratory results:
White blood cell count: 2500 cells/μL (reference range, 3500-10,500 cells/μL), with 65% neutrophils (reference range, 30%-60% neutrophils) and 18% bands
Hemoglobin: 5.8 g/dL (reference range, 12-15.5 g/dL)
Platelet count: 88,000 cells/μL (reference range, 150,000-400,000 cells μL)
Serum creatinine: 2.9 mg/dL (reference range, 0.6-1.2 mg/dL)
Serum urea: 54 mg/dL (reference range, 7-26 mg/dL)
Serum alanine aminotransferase: 124 U/L (reference range, 0-55 U/L)
Serum aspartate aminotransferase: 673 U/L (reference range, 5-34 U/L)
Serum bilirubin: 2.8 mg/dL (reference range, 0.2-1.2 mg/dL)
Serum lipase: 167 U/L (reference range, 8-178 U/L)
Serum lactate: 4.6 mmol/L (reference range, 0.5-2.2 mmol/L)
Serum ferritin: >21,000 ng/mL (reference range, 13-24 ng/mL)
Serum triglycerides: 385 mg/dL (reference range, <150 mg/dL)
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2) 50 year old patient with chronic liver cirrhosis presents with sudden abdominal distension and dispnoea (from medscape)
Laboratory findings:
Hematocrit 24%
platelet count 94,000 /μL
INR 1.95
total serum bilirubin 6.9 mg/dL (118 μmol/L)
fibrinogen 136 mg/dL (4 μmol/L)
serum potassium 2.9 mEq/L
lactate 26.1 mg/dL (2.9 mmol/L).
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3) 40 year old patient with weakness, fatigue, mental confusion, blood pressure 80/50 mmHg. Gradual onset since three months (from Merck).
Laboratory findings:
Hemoglobin 13 g/dL
sodium 125 mEq/L
potassium 5.7 mEq/L
sodium/potassium ratio 22 (normal value 30)
fasting glycemia 50 mg/dL
BUN 40 mg/dL
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4) 76 year old patient with fatigue, generalized weakness, lethargy, and > 10% unintentional weight loss. (from the Journal of Medical Case Reports)
Laboratory findings:
white blood cell count of 24,200 cells/μL (reference interval 4,000-10,000)
hemoglobin 12.6 g/dL (reference interval 12.0-15.0 g/dL)
platelets 119x103/μL (reference interval 150-450x103)
potassium 5.6 mmol/L (reference interval 3.5-5.0 mmol/L)
blood urea nitrogen (BUN) 55 mg/dL (reference interval 6-20 mg/dL)
creatinine 1.63 mg/dL (reference interval 0.80-1.20 mg/dL)
glucose 29 mg/dL (reference interval 64-100 mg/dL)
alkaline phosphatase 202 units/L (reference interval 20-130 units/L)
aspartate aminotransferase (AST) 273 units/L (reference interval 8-33 units/L)
alanine transaminase (ALT) 75 units/L (reference interval 4-36 units/L)
total bilirubin 2.1 mg/dL (reference interval 0.1-1.2 mg/dL) (direct bilirubin 1.7 mg/dL)
albumin 3.1 mg/dL (reference interval 3.4-5.4 mg/dL)
Hemogas analysis:
pH 6.93 (reference interval 7.35-7.45)
total CO2 7 mmol/L (reference interval 23-29 mmol/L)
lactate 19 units/L (reference interval 0-2 units/L)
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5) 9 months old baby (male) with stunted growth, pallor.
Laboratory findings:
hemoglobin 9 g/dL
erythrocytes 2.4x106/μL
mean corpuscular volume 106 fL (normal value 80-95 fL)
sodium 130 mEq/L
potassium 4.4 mEq/L
blood urea nitrogen (BUN) 15 mg/dL
creatinine 0.8 mg/dL
glucose 75 mg/dL
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6) Routine blood test in an asymtpomatic adult reveals:
Hemoglobin 11 g/dL
Erithrocytes 3x106/μL
Mean Corpuscular Volume MCV 73 fL (reference range 80-95 fL)
White Blood Cell 6,000/μL
Platelets 220,000/μL
I want to see the comments for this case
7) Routine blood test in an asymptomatic adult reveals:
Sodium 130 mEq/L
Potassium 4.2 mEq/L
Chloride 98 mEq/L
Triglycerides 140 mg/dL
Total cholesterol 380 mg/dL
Glycemia 85 mg/dL
BUN 16 mg/dL
Creatinine 0.7 mg/dL
Total bilirubin 0.8 mg/dL
I want to see the comments for this case
8) Fatigue and unintentional weight loss in a 67 years old patient.
Laboratory results of initial screening:
Hemoglobin 11.5 g/dL
Erythrocytes 3.2x106/μL
Mean Corpuscular Volume MCV 90 fL (reference range 80-95 fL)
White Blood Cell 3,500/μL
Platelets 180,000/μL
Sodium 134 mEq/L
Potassium 4.2 mEq/L
Chloride 102 mEq/L
Triglycerides 160 mg/dL
Total cholesterol 230 mg/dL
Glycemia 88 mg/dL
BUN 55 mg/dL
Creatinine 2.4 mg/dL
Total bilirubin 1.1 mg/dL
I want to see the comments for this case
9) Intense abdominal pain irradiating to the back in a young adult woman. Modest signs of peritoneal involvement.
Laboratory results of initial screening:
Hemoglobin 13.5 g/dL
Erythrocytes 4.0x106/μL
Mean Corpuscular Volume MCV 90 fL (reference range 80-95 fL)
White Blood Cell 8,500/μL
Platelets 240,000/μL
Sodium 138 mEq/L
Potassium 4.1 mEq/L
Chloride 101 mEq/L
Triglycerides 140 mg/dL
Total cholesterol 280 mg/dL
Glycemia 88 mg/dL
BUN 15 mg/dL
Creatinine 0.9 mg/dL
Total bilirubin 0.8 mg/dL
I want to see the comments for this case
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