Question

Test	Result	Reference
Na	158	135 - 145 mmol/L
K	4.6	3.5 - 5.0 mmol/L
Cl	118	93 - 108 mmol/L
HCO3	18	21- 28 mmol/L
Urea	16.5	3.0 - 8.9 mmol/L
Glucose	43	3.6 - 6.1 mmol/L
Osmolality	393	281- 297 mmol/kg
Ketones	negative	negative

1. An 80 year old patient was admitted to hospital with the following laboratory tests.
   1. Explain the Na results
   2. Calculate the serum osmolality and explain the significance of the result.
   3. Explain the HCO3 result
   4. What is the likely diagnosis?

Answer 1

Na results signify the hypernatremia. It is a condition where the serum sodium level is increased and loss of body water. The symptoms include restlessness, fatigue.

Serum osmolality helps to know the balance between the electrolyte and water level in the body. Serum osmolality level is 393 mmol/kg. Electrolyte such as serum sodium, chloride, bicarbonate, and blood glucose can cause increased serum osmolality level.

Bicarbonate a form of carbon dioxide helps to regulate our blood pH. The patient has a low bicarbonate level which leads to metabolic acidosis.

The above results denote that the patient is suffering from Diabetic Insipidus where the body is unable to regulate the body fluids.