FBC:
Hb 110 g/L (115-165)
WCC 10 x109/L (4-11)
Plt 315 x109/L (150-400)
MCH 27.5 pg (27-33)
MCV 82 fL (80-100)
CRP 5 mg/L (<5)
LFT:
ALT 20 IU/L (0-59)
ALP 105 IU/L (30-130)
Bili 20 umol/l (1-21)
Alb 40 g/l (35-50)
TFT
TSH 1.1 mIU/L (0.2 - 4)
T4 12 pmol/L (10 - 20)
Your consultant arrives to post-take
You present Mrs Howells and the blood results and you indicate that your SHO has helped you arranged a CT Head, which will be done soon
"So, what do you think the blood results indicate?"
Your consultant laughs, "That was unfair, the bloods mostly helped to reduce the likelihood of an infection and delirium as a cause of the confusion and/or fall. In this case it doesn't give us the diagnosis. The CT Head was a good call."
Bloods are usually unhelpful with regards to a vascular event. The history, clinical examination and a CT head are key.
The bloods are largely normal or borderline, not convincing of an infection. The white cell count (WCC) and the C-reactive protein (CRP) are some of the better indicators
The low Hb (Haemoglobin) can be related to a haemorrhage, but a slightly low Hb can often be an unrelated incidental finding.
Vascular event
Infection
Intracranial bleed
U&E:
Na+ 139 mmol/l (133-146)
K+ 4.4 mmol/l (3.5 - 5.3)
Cl- 102 mmol/l (95-108)
Urea 5.7 mmol/l (2.5-7.8)
Creat 79 umol/l (70-120)
EGFR 65 ml/min/1.73m2
Bone profile:
Ca2+ 2.3 mmol/L (adj, 2.2-2.6)
ALP 105 IU/L (30-130)
PO4- 1.0 mmol/L (0.8-1.5)
Glucose:
Random 7.0 mmol/L (3.0-7.7)
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