Pathology notes

Apr 16th, 2015
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Clinical chemistry caseClinical case A 1 yr old female admitted with crying alot, startles, and fever. Also had delayed milestones. No vomiting or diarrhea. On Examination, had frontal bossing,richitic rosary and widened wrist No bowing of the lower limbsInvestigations FBS- 5 mmol/l (2.8 -6mmol/l) Serum phosphates -1.5mmol/l (0.81.4mmol/l) ALP - 60U/L(30-50U/L)Other investigationsNa+ 105mmol/l( 135-145mmol/l)K + 3.8mmol/l (3.6-5.0mmol/l)Urea 3.1mmol/l(3.3-6.7mmol/l)Elisa for HIV negative. Comment on the results. Differential diagnosis? Serum calcium - 0.5mmol/l(2.2 -2.6mmol/l) Severe hypocalcaemia Rickets What other investigations should werequest on the patient?Other investigations that shouldhave been done Liver function tests, especially serumproteins PTH levels immunoassays Blood gas analysis alkalosis may lead toreduced free serum calcium levels due torelease of albumin bound H+ Renal function tests. ECG prolonged QT interval Radiological bone investigationsCalcium HomeostasisMaintenance of a constant Ca concentration inextracellular fluidsThree hormonesVitamin DParathyroid hormoneCalcitoninThree tissuesSmall intestineBoneKidneysCalcium Metabolism:Figure 23-20: Calcium balance in the bodyHormonal Regulation of Calcium andPhosphate Balance Decreased PlasmaCalcium Causes: Increased PTH Resulting in

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