Lauren Young:
'I don't feel very well'
ALT 22876!!!!!
'Oh yes, I forgot, I did take 140 paracetamol tablets 3 days ago'
Patient was transferred to liver transplant centre, don't know the outcome.
Priscilla Ng:
Patient with prostate cancer and constipation x 10 days, c/o urinary retention, catheterised, 4.2 litres!!! (creatinine was only 286 amazingly)
Rebecca Croke:
Once saw a lady with psychogenic polydipsia with Na 99 who survived..
Also saw DKA with pH 6.7, bicarb 1.4 and co2 8! also survived!
Amanda Brooks Was Caluori:
Once drained 42 litres off poor man looked 12 months pregnant.
Karen Faulkner:
Not an abnormal result, but by far the most impressive patient. We have a frequent attender, where he turns up drunk, falls asleep, wakes up again and leaves. New Years Eve he was brought in by police unrespnsive. GCS 9. Was sedated, intubated and ventilated. After a few hours his sedation was turned off and his blood alcohol level was taken - 800mg/ml!!! He was off sedation for 8hours before he started to gag on his tube!!! I'd love to know what his blood alcohol level was when he first came in!?!?!
Emma Chambers:
I've seen our full blood count analysers give neut count 0. I then had to confirm this by blood film, and I didn't find a sinlgle neutrophil.
Have also seen haemoglobins of 2-3 (the story of the sickler with Hb 0.5 is pretty scary!). We have a regular patient who blood lets into coke cans and will only accept transfusions of the volume she knows she has lost. She generally has 2 units every 6 weeks or so, and lives with a haemoglobin of about 4-5.
We had a new ITP over Christmas who actually had no platelets at all. I spent a long time looking at that blood film in the hope I might find one somewhere!
Helen Steele:
HbA1c: 20.2
Total cholesterol: 12
In a 15yo type 1 diabetic with "Mauriac" sydrome of acute fatty liver related to poor sugar control. Her liver edge was in her RIF and as such was missed on initial physical exam. An ARX showed complete white-out due to the liver.
Also 3 weeks later her HbA1c reduced to 11. According to everyone this is physically impossible, but we checked it twice!
Key Words:
paracetamol, prostate cancer and constipation, GCS, blood alcohol level, haemoglobin, HbA1c
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