Clinical case tutorial

A 69 year old gentleman presented to his GP with lower back pains for the last six weeks.

Liver profile:

• Total protein 69 g/L (61 – 79)
• Albumin 23 g/L (35 – 48 g/L)
• Bilirubin 10 umol/L (0 – 20)
• ALT 11 iu/L (10 – 40)
• Alkaline Phosphatase 955 iu/L (39 – 137 iu/L)

Bone profile:

• Calcium 2.14 mmol/L
• Adjusted calcium 2.29 mmol/L (2.15 – 2.6)

FBC:

• Hb 71 g/L (130 – 170 g/L)
• WBC 5.5 109/L (4 – 11)

Electrolytes and urea and eGFR were satisfactory.

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