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7036BMS Case Studies Case Study 4 A 15-year-old girl broke her wrist following a low-impact fall in his house. She was not known to be very active but did not have a history of ill health. Her mother informed the clinical staff that she ate well although she was worried as he had recently decided to follow a vegan diet and had been on it for a few weeks. The fracture clinic ordered some blood tests, and the results are given in the table below. Analyte Result Reference range Units Sodium 141 136-146 mmol/L Potassium* 4.3 3.5-5.5 mmol/L Chloride 100 96-110 mmol/L Urea 2.3 2.5-8.3 mmol/L Creatinine 57 21-65 Umol/L Glucose 3.7 3.5-5.8 mmol/L mmol/L Serum calcium 1.6 2.1-2.6 mmol/L Serum intact PTH 7.5 1.6 – 6.9 pmol/L Serum 25(OH)D 15 >50 nmol/L Serum alkaline phosphatase 165 30-180 U/L • Identify potential causes to the presenting problem. • Critically review the case study and establish a differential diagnosis. • Use the biochemical results and the biochemistry to support your answer throughout. find provisional diagnosis

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