A 67 year old man is brought to your Emergency Department by ambulance. He is 7 days post right total knee replacement, complaining of feeling generally unwell and a painful right knee. He has had a previous cholecystectomy.

Vitals:

BP 120/60,           PR 140-160/min irregular

Temp 40               RR 20/min, O2 sats 90% RA

On examination:

Jaundice

Chest clear

Abdomen soft and non tender

Describe and interpret the following bloods:

Hb 116 (135-180)                                           CRP  190 (<10)

WCC 9.3 (4-11)                                               INR 1.1(0.9-1.3)

Platelet 377 (150-400)                                    Lactate 2.2 (<1.5)

Neutrophils 8.60 (4-6)

Total protein 76 (60-80)

Albumin 43 (35-50)

Bilirubin 206 (<20)

ALT 381 (<40)

Alk Phos 542 (<135)

GGT 2590 (<60)

Lipase 99 (20-210)