Case Studies BIOCHEM 3H03

Mr. K, 54-year-old male with Type 2 diabetes mellitus, poorly controlled, hyperlipidemia, history of

alcohol abuse.

Mr. K presented with mild fatigue and a general feeling of weakness. No confusion, seizures, or other

neurological symptoms. He reported no excessive fluid intake.

Lab Results:

Sodium (Na+): 125 mmol/L [133-146 mmol/L]

Serum Glucose: 10 mmol/L (elevated)

Total Cholesterol: 18 mmol/L (very high)

Serum Osmolality: 294 mmol/kg [275-295 mmol/kg]

What can you say about these values and what is your diagnosis

Diagnosis: Pseudohyponatremia due to hyperlipidemia

Female patient of 58 years old has undergone major surgery a day and

a half ago and still receiving hypotonic fluid replacement.

The patient is alert, no other signs

The test results show:

Sodium 127 mmol/L [133-146 mmol/L]

All other tested values are within range

What is going on here?

Dilutional hyponatremia

Female patient of 86 years arrives at the emergency with signs of

confusion and extreme weakness. She lives alone with her family

visiting her every other day. They say she was fine and quite alert in

their last visit together.

Routine testing reveals

Plasma sodium concentration of 167 mmol/L [133-146 mmol/L]

Clinical examination: reduced skin turgor, low BP

hypernatremia

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