Jason D., a 53 year old male, went to his family physician for an “annual” physical exam. His last physical exam containing bloodwork was four years prior. Jason’s medical history shows that he is slightly overweight, a non-smoker and drinks alcohol 3-4 times per week. He has a family history (father and paternal grandfather) of myocardial infarction before age 55, cancer (maternal grandmother) and stroke (mother). His routine screening results are below:
(Comprehensive Metabolic Panel)
Results
Reference Range
Sodium
143
136-145 mEq/L
Potassium
4.6
3.6-5.0 mEq/L
Chloride
109
101-111 mEq/L
CO2
29.0
24.0-34.0 mEq/L
Glucose
95.0
70-99 mg/dL
BUN
16
7-24 mg/dL
Creatinine
1.0
0.5-1.2 mg/dL
Bilirubin Total
0.7
0.2-1.2 mg/dL
AST
32
5-40 IU/L
ALP
80
30-157 IU/L
Protein
7.5
6.0-8.4 g/dL
Albumin
4.6
3.5-5.0 g/dL
Calcium
8.5
8.5-10.5 g/dL
Cholesterol
355
<200 mg/dL
List all abnormal results
List (5) secondary causes (caused by other conditions) associated with the abnormal result listed above.
Of your (5) listed causes, which can you rule out using Jason’s medical history and current lab results?
What is the most probable cause of the abnormal results?
What follow-up lab testing should the physician order for more detailed information about Jason’s condition?