April 2021 – Dieter's Portfolio

HOSP # Req#452050196 WARD Pathcare Private CONSULTANT John Stanfliet / Jody Rusch DOB/AGE Unknown Abnormal Result Presenting Complaint This was a case discussed in consultation with a private consultant: 50

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

Falsely decreased total cholesterol

By Dr. Janet Simons on June 26, 2019 By Dr. Janet Simons (biography, no disclosures) What gap I have noticed Calcium levels are commonly ordered in both primary and acute care in patients 50

Disease summaries Endocrine

Correcting the Myth of Calcium Correction

HOSP # MRN63985901 WARD Medical Ward CONSULTANT Dr. Heleen Vreede DOB/AGE 51 year Female Abnormal Result Total calcium of 1.47 mmol/L (2.15 – 2.50) Presenting Complaint The patient has 50

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

A case of persistent hypocalcemia

The patient, a 16 y female presented with signs and symptoms of an upper urinary tract infection.

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

Cystine crystals in the urine

A case of falsely raised succinate

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

High succinate in the urine

Although not strictly a patient case, I will discuss the applicability of 3D printing in the laboratory in two particular problems which presented itself in our laboratory.

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

3D Printing in the laboratory

This patient likely has a combination of aetiologies accounting for the deranged electrolytes.

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

Hypernatremia with hypokalemia

Method Bicarbonate is the second largest fraction of the anions in plasma. Included in this fraction are the bicarbonate (HCO3–) and carbonate (CO32-) ions, as well as the carbamino compounds. 50

Methods

Bicarbonate HCO3 CO2 CO3

A child with an increased fecal osmolar gap

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

Raised fecal osmolar gap

HOSP # WARD GIT clinic CONSULTANT Dr. Heleen Vreede DOB/AGE 59 y male Abnormal Result Faecal calprotectin >6000 ug/g stool Presenting Complaint 59 y male, presenting with diarrhoea and 50

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

Raised fecal calprotectin

HOSP # WARD CONSULTANT DOB/AGE 15 y girl Abnormal Result This patient was discussed at a combined Endocrinology / Chemical Pathology meeting. Total bilirubin: 281 umol/L Presenting Complaint The 50

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

Primary amenorrhoea with ulcerative colitis

HOSP # WARD Neurosurgery CONSULTANT Dr. Jody Rusch DOB/AGE 10 year female Abnormal Result Prolactin >1000 ug/L Presenting Complaint Patient presented at 7 years of age with galactorrhea and 50

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

Hyperprolactinemia >1000

HOSP # Mr JB WARD Endocrine Department – CathLab – UCT private Hospital CONSULTANT Dr Jody Rusch DOB/AGE 53y Male Abnormal Result Upon authorizing blood results I came across 50

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

Bilateral adrenal vein sampling

Patient presented with a few isolated episodes of muscle weakness. This progressed from 2 weeks before, during the index episode, to become so severe that he couldn't walk.

Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases

A likely case of thyrotoxic periodic paralysis

HOSP # Mrs DW WARD Endocrine Department – CathLab – UCT private Hospital CONSULTANT Dr Jody Rusch DOB/AGE 49y Female Abnormal Result 49yr old female Presenting Complaint Medical complaint: 50

Disease summaries Section 8.2 - Evidence of Clinical Case Learning (Short Cases) Short cases