July 2014 - Overdose

(dates may look awry – only just got round to writing this up…)

Here’s an interesting case – I didn’t really realise this… A two days post overdose case.Paracetamol levels are fine…. But look at the liver function tests. People often survive paracetamol overdoses only to die of complications of liver failure a few days later…

GRIFFIN, MEG                                                  17/07/2014 08:45 MISS  11/07/1995 19 yrs  F  01234567             Clinical Decision Unit QUAHOG                   Specimen No : AC669379A    Haematology & Chemistry        <PgUp/PgDn> for more -------------------------------------------------------------------------------- 17/07/2014 08:45  Serum/Plasma  Request Reason :     PARACETAMOL OD   Sodium                         139    mmol/L          (   133 to 146   ) Auth   Potassium                      3.6    mmol/L          (   3.5 to 5.3   ) Auth   Urea                           2.5    mmol/L          (   2.5 to 7.8   ) Auth   Creatinine                     61     umol/L          (    49 to 90    ) Auth   GFR (estimated)                >90    units=*                            Auth   Total Protein                  56     g/L             (    60 to 80    ) Auth   Albumin                        33     g/L             (    35 to 50    ) Auth   Globulin                       23     g/L             (    20 to 35    ) Auth   Total Bilirubin                14     umol/L          (     0 to 22    ) Auth   Alkaline Phosphatase           81     U/L             (    30 to 130   ) Auth   ALT                            915    U/L             (     0 to 50    ) Auth   Paracetamol                    <10    mg/L                               Auth   Haemolysis-Integra             ^0.0                                      Auth -------------------------------------------------------------------------------- 1 Spec  2 Patient  3 Date  4 pRint  5 cUm  6 DFT  7 Verbose  8 Options 9 eXit X  Di            Sect: CC            David Styles       SRE/APEX    Overtype

GRIFFIN, MEG                                                  17/07/2014 08:45 MISS  11/07/1995 19 yrs  F  01234567             Clinical Decision Unit QUAHOG                   Specimen No : AC669379A    Haematology & Chemistry        <PgUp/PgDn> for more ------T-----------------------------------------------------------------------]   Date|17/07/2014 16/07/2014 15/07/2014 07/07/2014 04/06/2014 03/06/2014      |   Time|08:45      16:30      u/k        10:40      04:30      02:51           |   Spec|AC669379A  AC668910W  AC668134L  AG213350F  AC630007S  AC628785T       |       |BIO        BIO        BIO        BIO        BIO        BIO             | Test--+-----------------------------------------------------------------------{ NA    |139        138        139        137        140        141             | K     |3.6        3.5        3.8        3.8        3.8        3.9             | U     |2.5        4.3                              1.7        3.3             | CR    |61         57         58         61         56         61              | _GFR  |>90        >90        >90        >90        >90        >90             | PROT  |56         60         61                    63         65              | ALB   |33         35         37                    36         38              | GLOB  |23         25         24                    27         27              | TBIL  |14         24         9                     19         9               | ALKP  |81         83         89                    76         84              | ALT   |915        79         26                    68         102             | PARA  |<10        <10        145                   <10                        | ------T-----------------------------------------------------------------------]   1 View   2 Graph   3 eXit  X                             Cursor Down for more                       More >>