Category Archives: Clinical biochemistry


(From Pulse learning module) Mild hyponatraemia: 130 – 132 Moderate hyponatraemia: 125 – 129 Severe/profound hyponatraemia: <125 (some experts use ‘profound’ for <110). This category was picked on the basis of patients being increasingly likely to be symptomatic below this … Continue reading

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(From Pulse on-line learning module) Mild: <2.88 Moderate: 2.88 – 3.4 Severe: >3.4 If the level is mild or moderate (i.e. 3.4 or less) and the patient is asymptomatic, repeat within the next week. Fasting bloods may be more accurate … Continue reading

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Hypocalcaemia is mild if 1.9 or higher, severe below. Mild hypocalcaemia is usually asymptomatic and can be treated with a follow-up within the next 7 – 10 days, with giving supplements (including Vitamin D if needed), and with consideration of … Continue reading

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Hypertriglyceridaemia is probably an independent risk factor for cardiac disease, but so far it hasn’t been possible to establish this for certain. (Interestingly, any relationship may be in a U-shaped curve, though it’s not at all clear where the peak … Continue reading

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Borderline TFTs

May represent early stages of thyroid disease. If the patient is asymptomatic, the first action should always be to repeat the tests to exclude lab error. Low TSH with normal T4/T3: Repeat within a fortnight. If stable, in a young … Continue reading

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Investigation of raised ALP

Physiological causes Normal variation – statistically, 2.5% of the population will have levels above the ULN. Analytical variation – combined analytical & biochemical variation is approx 8%. Levels increase by approx 6% if sample stored for 96 hrs at room … Continue reading

Posted in BMJ, Clinical biochemistry, Credits 2013, Gastroenterology, Liver, Liver | Leave a comment

BMJ 2011: 342: 557 – 606 (12th March)

If a patient’s ear discharge doesn’t seem to be clearing up satisfactorily with the usual otitis externa treatment, or if it’s very recurrent and you can’t get a good look at the eardrum, consider whether the problem might actually be … Continue reading

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