A chemistry panel shows glucose 24.8 mmol/L (↑), total protein 33 g/L (↓), Na 128 mmol/L (↓), K 2.1 mmol/L (↓). What is this indicative of?

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Multiple Choice

A chemistry panel shows glucose 24.8 mmol/L (↑), total protein 33 g/L (↓), Na 128 mmol/L (↓), K 2.1 mmol/L (↓). What is this indicative of?

When a lab panel shows a very high glucose together with lower total protein, sodium, and potassium, think about a preanalytical interference rather than a disease process. If the blood is drawn from an arm with an active dextrose-containing IV infusion, the sample gets mixed with the IV fluid, spiking the glucose measurement. The IV fluid also dilutes the plasma, lowering concentrations of other constituents like sodium, potassium, and total protein. This pattern is classic for IV-dextrose contamination of the specimen, making this option the best explanation. Hemolyzed samples typically raise potassium and can alter other values in inconsistent ways, not producing this coordinated low Na, low K, and low protein with a high glucose. Dehydration would usually concentrate (not dilute) plasma constituents, often raising sodium and protein rather than lowering them. Lab error is possible but doesn’t specifically account for the concurrent glucose elevation from IV dextrose.

When a lab panel shows a very high glucose together with lower total protein, sodium, and potassium, think about a preanalytical interference rather than a disease process. If the blood is drawn from an arm with an active dextrose-containing IV infusion, the sample gets mixed with the IV fluid, spiking the glucose measurement. The IV fluid also dilutes the plasma, lowering concentrations of other constituents like sodium, potassium, and total protein. This pattern is classic for IV-dextrose contamination of the specimen, making this option the best explanation.

Hemolyzed samples typically raise potassium and can alter other values in inconsistent ways, not producing this coordinated low Na, low K, and low protein with a high glucose. Dehydration would usually concentrate (not dilute) plasma constituents, often raising sodium and protein rather than lowering them. Lab error is possible but doesn’t specifically account for the concurrent glucose elevation from IV dextrose.

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