Name___________________________________

Whichizit

MLS-2213

You and Jayson Clarke have been performing Basic Metabolic Panels (BMPs) and other selected tests on several patients.   You have been performing all of the analytical work, but Jayson has been setting up the specimens on the analyzer for you and programming all of the patient’s tests.    Unfortunately, Jayson has completely failed to program the patients’ names and accession numbers for the tests! 

Shortly after you finished showing Jayson how to polish the inside of the -70^o C Freezer, you came back and you are now looking at the chemistry analyzer’s printouts.   Although you cannot legally report any of the patients’ values, you thought it would be fun to try to figure out to whom each Basic Metabolic Panel belongs.   Here are the patients and their current diagnoses:

Chin Yong                            Diabetes Mellitus, Type 1 (unstable, ketoacidosis)

Amanda Willis                    Diabetes Mellitus, Type 2

Younger Keneval               Motorcycle Accident, Trauma 1

Luigi Tafori                        Advanced Addison’s Disease

Lulu Sharpelli                     Advanced Anorexia Nervosa (with Bulemia)

Thomas Rex                        Advanced Conn’s Disease

Asif Al Syedif                      Acute Renal Failure

Joseph Lonetree                 Cushing’s Disease

Kjordi Kjeldgdatter          Acute Salicylate Poisoning

Match each of these patients with their most probable chemistry panel results, and explain exactly why the results match that patient more closely than any of the others:

Panel 1                  Sodium                  126 mMol/L         Here’s who it is, and here’s why:

                                Potassium             6.1 mMol/L

                                Chloride                 80 mMol/L

                                Bicarbonate          12 mMol/L

                                Glucose                  443 mg/dL

                                BUN                         14 mg/dL

                                Creatinine             0.8 mg/dL
                                Calcium                 10.0 mg/dL

                                Lactate                  1.5 mMol/L

Panel 2                  Sodium                  144 mMol/L         Here’s who it is, and here’s why:

                                Potassium             6.0 mMol/L

                                Chloride                 93 mMol/L

                                Bicarbonate          15 mMol/L

                                Glucose                  93 mg/dL

                                BUN                         63 mg/dL

                                Creatinine             1.9 mg/dL
                                Calcium                 8.6 mg/dL

Lactate                  8.5 mMol/L 

Panel 3                  Sodium                  129 mMol/L         Here’s who it is, and here’s why:

                                Potassium             5.9 mMol/L

                                Chloride                 90 mMol/L

                                Bicarbonate          26 mMol/L

                                Glucose                 63 mg/dL

                                BUN                         14 mg/dL

                                Creatinine             0.8 mg/dL

                                Calcium                 9.6 mg/dL

                                Lactate                  0.8 mMol/L 

Panel 4                  Sodium                  136 mMol/L         Here’s who it is, and here’s why:

                                Potassium             5.1 mMol/L

                                Chloride                 94 mMol/L

                                Bicarbonate          20 mMol/L

                                Glucose                  183 mg/dL

                                BUN                         19 mg/dL

                                Creatinine             0.9 mg/dL
                                Calcium                 8.9 mg/dL

                                Lactate                  1.3 mMol/L

Panel 5                  Sodium                  130 mMol/L         Here’s who it is, and  here’s why:

                                Potassium             6.0 mMol/L

                                Chloride                 83 mMol/L

                                Bicarbonate          14 mMol/L

                                Glucose                  71 mg/dL

                                BUN                         44 mg/dL

                                Creatinine             4.8 mg/dL
                                Calcium                 9.9 mg/dL

                                Osmolality            326 mOsm/Kg

Panel 6                  Sodium                  135 mMol/L         Here’s who it is, and here’s why:

                                Potassium             5.6 mMol/L

                                Chloride              110 mMol/L

                                Bicarbonate          14 mMol/L

                                Glucose                  73 mg/dL

                                BUN                       88 mg/dL

                                Creatinine             7.8 mg/dL
                                Calcium                 7.1 mg/dL

                                Osmolality            316 mOsm/Kg 

Panel 7                  Sodium                  153 mMol/L         Here’s who it is, and here’s why:

                                Potassium             3.2 mMol/L

                                Chloride              112 mMol/L

                                Bicarbonate          30 mMol/L

                                Glucose                  123 mg/dL

                                BUN                         14 mg/dL

                                Creatinine             0.8 mg/dL
                                Calcium                 8.6 mg/dL

                                Lactate                  1.3 mMol/L 

Panel 8                  Sodium                  158 mMol/L         Here’s who it is, and here’s why:

                                Potassium             3.1 mMol/L

                                Chloride                 117 mMol/L

                                Bicarbonate          26 mMol/L

                                Glucose                  109 mg/dL

                                BUN                         18 mg/dL

                                Creatinine             1.0 mg/dL
                                Calcium                 8.6 mg/dL

                                Serum Ketones     Normal          

Panel 9                  Sodium                  125 mMol/L         Here’s who it is, and here’s why:

                                Potassium             3.5 mMol/L

                                Chloride                 90 mMol/L

                                Bicarbonate          16 mMol/L

                                Glucose                  54 mg/dL

                                BUN                       12 mg/dL

                                Creatinine             0.9 mg/dL
                                Calcium                 8.0 mg/dL

                                Serum Ketones     Elevated