# Lab case 449

87 year old man with history of COPD and type 2 DM on insulin and metformin, was found unconscious. His VBG showed the following.

PH = 7.23

# Lab case 448 Interpretation

Question 1:

We should consider ascending cholangitis in any patient with fever and features of obstructive jaundice till prove otherwise.

The diagnosis of ascending cholangitis is a clinical diagnosis. Classic Charcot triad of abdominal pain, fever, and jaundice seen only in about 40% of patient.

# Lab Case 448

75 year old lady presented to the emergency department after a fall. In ED she was found to be slightly febrile with blood pressure of 95/55. Part of the investigation performed was LFT   and it showed the following:

Bilirubin = 101  umol/L     (< 16)

# Lab case 447 interpretation

Question 1:

• Hb = 76 (between 7 and 9.9) = moderate anaemia.
Normal MCH and MCV so we have normochromic anaemia.
• WBC = 1.5 (N = 0.9) = mild leukopenia with moderate neutropenia.
• Platelets = 31 (between 70 and 20) = moderate thrombocytopenia.

# Lab case 447

21 year old girl presented with sudden left sided weakness. Her CT head showed intracerebral haemorrhage. Her full blood picture showed the following:

# Lab case 446 interpretation

PH = 7.238, that is moderate acidaemia.

pCO2 = 49.1 mmHg. that is suggestive of respiratory acidosis

HCO3 = 20.2 mmol/L, that is suggestive of metabolic acidosis.

# Lab case 446

The following blood gases results were given to a doctor to sign, explain the findings

PH = 7.238

pCO2 = 49.1 mmHg

pO2 = 47.7 mmHg

# lab case 445 interpretation

Ph = 7.51, that is mild alkalaemia.

HCO3 = 47.5 mmol/L. So, we have metabolic alkalosis.

# Lab case 445

85 year-old-woman with fracture of right neck of femur. Her blood gases showed the following:

PH = 7.51

pCO2 = 59.5 mmHg

pO2 = 70 mmHg

HCO3 = 47.5 mmol/L