I have had a couple of "vigorous, prolonged fist clencher
Peadar,
I have had a couple of "vigorous, prolonged fist clenchers" who keep on clenching unless told to stop. Could be worth asking about as well as the other usuals.
Graham
Graham Jones
Staff Specialist in Chemical Pathology
St Vincent's Hospital, Sydney
Ph: (02) 8382-9160
Fax: (02) 8382-2489
>>> Peadar McGing <[log in to unmask]> 12/01/2008 12:25:44 am >>>
Dear colleagues,
I know this is a topic aired many times and I've written about it myself but
I am currently dealing with a case that doesn't quite fit the bill and I
wonder if anyone can offer some advice.
The case is of a woman in her 50s who had blood taken by her GP and sent via
the normal courier system to the lab.
Patient was asymptomatic.
Sample was sent in on the 8th and repeated on the 9th. Because of the high K
which was phoned by the lab, the GP sent her in to AE which she attended the
next day (10th).
Date Na K Cl TCO2 Urea Creat A.G.
8-1-08 (GP) 151 5.1 107 28 4.2 74 21
9-1-08 (GP) 150 6.6 109 34 3.7 79 14
10-1-08(AE) 138 3.8 102 27 3.3 61 13
ref ranges: Na (133-145), K(3.5-5.0).
Units mmol/L except creat (µmol/L)
GP said patient is on a lot of medications, including anti-depressants, but
the most notable 'medication' was that she was described as 'taking food
with her rather salt than taking salt with her food'.
We can't rule out refrigeration but we believe it unlikely as a cause in
this case.
We have some idea but things don't add up fully and I'd appreciate your
thoughts, especially if you've seen this scenario before.
best wishes.
Peadar
Dr Peadar McGing, MRCPath EurClinChem,
Principal Biochemist,
Biochemistry Dept., Mater Misericordiae University Hospital,
Eccles Street, Dublin 7, Ireland.
Tel: (+353 1)8032080; Fax: (+353 1)8034781.
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