A 16-year-old male athlete was admitted to the Emergency due to fluid loss. His blood biochemistry results were:Analyte (SERUM)ResultReference intervalSodium158135 – 145 mmol/LPotassium6.03.5 – 5.5 mmol/LChloride12095 – 110 mmol/LBicarbonate1422 – 32 mmol/LUrea263.0 – 8.0 mmol/LCreatinine14240 – 90 μmol/LCreatinine kinase857< 250 IU/LLactate20.1< 3.0 mmol/LLactate was elevated by ~7-fold. What is the likely cause of this?                Group of answer choicesAnaerobic metabolismArtefact due to dextrose-saline intravenous fluidArtefact due to 5% dextrose intravenous fluidArtefact due to 0.9% NaCl intravenous fluid

A 30-year-old man was administered in the Accident and Emergency (A&E) department of a metropolitan hospital. He appeared partially conscious and extremely weak. His biochemical blood results are:Analyte (SERUM)ResultReference intervalSodium121135 – 145 mmol/LPotassium5.63.5 – 5.5 mmol/LChloride8695 – 110 mmol/LBicarbonate1922 – 32 mmol/LUrea10.93.0 – 8.0 mmol/LCreatinine9840 – 90 μmol/LSerum osmolality340275 – 295 mOsm/kgWhat could have explained his altered serum electrolytes and osmolality?Group of answer choicesHe has acute kidney injury (AKI)Uncontrolled hyperglycaemiaHe has Conn’s syndromeHe has chronic kidney injury (CKD)

A 36-year-old man presents with the following blood biochemistry results:Analyte (SERUM)ResultReference intervalSodium146135 – 145 mmol/LPotassium6.83.5 – 5.5 mmol/LChloride10895 – 110 mmol/LBicarbonate2222 – 32 mmol/LUrea36.63.0 – 8.0 mmol/LCreatinine37740 – 90 μmol/LeGFR50> 90 ml/min/1.73m2Considering the abnormal results, what is the likely diagnosis for this patient?Group of answer choicesHe has acute kidney diseaseHe is on thiazide diureticsHe has metabolic acidosisHe has chronic diarrhea

A 48-year-old man felt drowsy. He was alone at home on a warm Australia Day long weekend. He collapsed in the backyard and was fortunately discovered by his son later. He was sent to the Emergency department. His blood biochemical results are:Analyte (SERUM)ResultReference intervalSodium158135 – 145 mmol/LPotassium5.53.5 – 5.5 mmol/LChloride11895 – 110 mmol/LBicarbonate2922 – 32 mmol/LFasting glucose3.83.6 – 5.5 mmol/L* Note: Urine osmolality is normalWhat is the likely reason explaining his high sodium result?Group of answer choicesExcessive loss of body fluidDiabetes insipidusOsmotic diuresis due to diabetes mellitusAddison’s disease

A female patient of 25 years old is recovering in the post-operative care unit in the hospital. Her blood biochemistry results are:         Analyte (SERUM)ResultReference intervalSodium131135 – 145 mmol/LPotassium5.03.5 – 5.5 mmol/LChloride11295 – 110 mmol/LBicarbonate2922 – 32 mmol/LFasting glucose3.83.6 – 5.5 mmol/Lcalcium2.22.15 – 2.55 mmol/LLactate25< 3.0 mmol/LHow would you explain the abnormal results?Group of answer choicesArtefact due to Hartmann’s solution intravenous fluidArtefact due to 5% dextrose intravenous fluidHypoglycaemiaMetabolic acidosis

A 63-year-old woman suffers from congestive heart failure. She went to see her cardiology for routine monitoring of her conditions. She presented the following results:Analyte (SERUM)ResultReference intervalSodium146135 – 145 mmol/LPotassium6.83.5 – 5.5 mmol/LChloride10895 – 110 mmol/LBicarbonate2222 – 32 mmol/LUrea36.63.0 – 8.0 mmol/LCreatinine37740 – 90 μmol/LeGFR50> 90 ml/min/1.73m2What has caused the raised potassium?Group of answer choicesInhibition of Na/K/ATPase pump by medicationTumour lysis syndromeOsmotic diuresisShe has metabolic alkalosis