Initial laboratory studies

Initial testing evaluated thyroid, electrolyte, and renal status. Though it is clear that additional testing will be required for final diagnosis, these tests are important in helping to direct the choice of the final diagnositic tests.

                         Patient                Reference
Hemoglobin (B)          9.4 g/dl               11.7 - 15.5
Sodium (S)              126 meq/l                136 - 145
Potassium (S)           5.8 meq/l                3.5 - 5.1
Chloride (S)             98 meq/l                 98 - 107
CO2, total (S)           20 meq/l                  23 - 29
Creatinine (S)          1.8 mg/dl                0.7 - 1.2
Urea nitrogen (S)        52 mg/dl                   7 - 18
BUN/creatinine ratio     29:1                  12:1 - 20:1
Calcium (S)            11.3 mg/dl               8.4 - 10.2
Phosphorus (S)          2.6 mg/dl                2.7 - 4.5
TSH (S)                 9.8 uU/ml                0.4 - 5.5

Urinalysis normal

Chest x-ray and EKG essentially normal

Questions

  1. What do you think of the patient's BUN and creatine results?
  2. How would you interpret the rest of the results?
  3. What tests would you want to carry out next?