1) These are the values of oral glucose tolerance test (glucose oxidase method) performed on an

individual. What is your interpretation?

Fasting 1/2 hr. 1 hr. 1 ½ hr. 2 hr.

Blood glucose
(mg/dl) 70 110 140 120 75

Urine sugar
Nil Nil Nil Nil Nil

2) These are the values of oral glucose tolerance test (glucose oxidase method) performed on an
individual. What is your interpretation?

Fasting 1/2 hr. 1 hr. 1 ½ hr. 2 hr.

Blood glucose
(mg/dl)
70 105 150 110 75

Urine sugar
Nil + + + Nil

3) These are the values of oral glucose tolerance test (glucose oxidase method) performed on an
individual. What is your interpretation?

Fasting 1/2 hr. 1 hr. 1 ½ hr. 2 hr.

Blood glucose
(mg/dl)
110 185 195 180 165

Urine sugar
Nil ++ +++ + Trace

1
4) These are the values of oral glucose tolerance test (Glucose oxidase method ) performed on
an individual. What is your interpretation?

Fasting ½ hr. 1 hr. 1 ½ hr. 2 hr.

Blood
Glucose 210 290 360 400 450
(mg/dl)
Urine + ++ +++ +++ ++++
Sugar
Urine Nil Nil + + +
acetone

5)

Time in Minutes
Urine sugar:
Fasting – Nil
½ hour – Nil
1 hour – Nil
1.5 hours – Nil
2 hours – Nil

6)

2
 Time in Minutes
Urine sugar:
Fasting – Nil
½ hour –+
1 hour – ++
1.5 hours – ++
2 hours –+

7) Comment on the following biochemical data.

Blood :
Serum calcium 7.2 mg/dl
Serum phosphorus 6.9 mg/dl
Serum alkaline phosphatase 27 IU/L
Serum total proteins 6.9 g/dl
Urine :
Calcium excretion 340 mg/day
Phosphorus excretion 420 mg/day

8)
3
 Time in Minutes
Urine sugar:
Fasting – Nil
½ hour –+
1 hour –+
1.5 hours –+
2 hours – Nil

9) Comment on the following biochemical data:

Blood:
Serum calcium 9.6 mg/dl
Serum phosphorus 4.1 mg/dl
Serum alkaline phosphatase 105 IU/L
Serum total proteins 6.8 g/dl
Urine:
Calcium excretion 220 mg/day
Phosphorus excretion 800 mg/day

4
10) Comment on the following biochemical data

Blood:
Serum calcium 11.6 mg/dl
Serum phosphorus 1.3 mg/dl
Serum alkaline phosphatase 734 IU/L
Serum total proteins 6.9g/dl
Urine:
Calcium excretion 120 mg/day
Phosphorus excretion 1800 mg/day

11) A 55year old business woman underwent medical screening programme provided by the
company as part of annual health checkup including assessment of thyroid function. Interpret the
biochemical investigations.

Serum TSH 4.5 μIU/ mL (0.3 – 5 μIU/mL)

Free T4 1.8 ng / dL (0.8 – 2.7 ng/dL)
Free T3 380 pg / dL (210- 440 pg/dL)

12) A 24 yr old physiotherapist consulted his general practioner because of excessive moistness
of his skin and was also concerned that his eyes seemed to have become more prominent and that
he had lost weight although his appetite was unchanged . On examination, his doctor observed
that his pulse rate was 98 / min at rest and that he had a slightly enlarged thyroid gland
Investigations:
Serum TSH < 0.1 mIU/ mL (0.3 – 5 μIU/mL)
Free T4 3.2 ng/ dL (0.8 – 2.7 ng/dL)
Free T3 880 pg/ dL (210- 440 pg/dL)
An isotopic scan of the thyroid showed an enlarged gland with increased uptake. Autoantibodies
to thyroperoxidase and thyroglobulin were present in serum in high titres

13) A senior civil servant was persuaded to seek medical advice because of his increasingly
bizarre behaviour. He had slowed down mentally, became indecisive and had given up his daily
game of tennis claiming that he no longer had energy to play. He has become intolerant to cold
weather and developed constipation. His voice had changed. His skin has become dry.
On examination,his physician observed a pulse rate of 60/min and his ankle & knee jerks
were sluggish. There was no goitre.
Investigations:
Serum TSH 25 μIU/mL (0.3 – 5μIU/mL)
Free T4 0.4 ng/dL (0.8 – 2.7 ng/dL)
Free T3 180 pg/dL (210- 440 pg/dL)
Serum cholesterol 520 mg/dL
14) The following are some of the biochemical findings in a patient. What is your probable
diagnosis?

5
 Serum
Total bilirubin 0.9 mg/dl
Conjugated 0.3 mg/dl
Unconjugated 0.6 mg/dl
AST 14 IU/l
ALT 8 IU/l
Alkaline phosphatase 65 IU/L
Urine
Bile salts Negative
Bile pigments Negative
Urobilinogen Present in normal
amounts
Faeces : Colour Normal

15) The following are some of the biochemical findings in a patient. What is your probable
diagnosis?
Serum
Total bilirubin 12.6 mg/dl
Conjugated 5.9mg/dl
Unconjugated 6.7 mg/dl
AST 232 IU/l
ALT 342 IU/l
Alkaline phosphatase 321 IU/l
Urine
Bile salts Positive
Bile pigments Positive
Urobilinogen Negative
Faeces : Colour Light coloured

16) The following are some of the biochemical findings in a patient. What is your probable
diagnosis?
Serum
Total bilirubin 22.2 mg/dl
Conjugated 20.4 mg/dl
Unconjugated 1.8 mg/dl
AST 14 IU/l
ALT 6 IU/l
Alkaline phosphatase 540 IU/l
Urine
Bile salts Positive
Bile pigments Positive
Urobilinogen Negative
Faeces : Colour Clay coloured

6
 17) The following are some of the biochemical findings in a patient. What is your probable
diagnosis?
Serum
Total bilirubin 6.5 mg/dl
Conjugated 0.4 mg/dl
Unconjugated 6.1 mg/dl
AST 16 IU/l
ALT 9 IU/l
Alkaline phosphatase 32 IU/l
Urine
Bile salts Negative
Bile pigments Negative
Urobilinogen Present in increased amounts
Faeces : Colour Dark coloured

18) 24-year old student was investigated for fever, nausea and abdominal pain.
Give your interpretation from the following laboratory results.
Serum Bilirubin (Total): 0.7 mg/dL
Serum Bilirubin (Conjugated): 0.2 mg/dL
Serum Bilirubin (unconjugated): 0.5 mg/dL
Aspartate Amino Transferase: 34 U/L
Alanine Amino Transferase : 21 U/L
Serum Alkaline Phosphatase: 87 U/L
Urinary findings:
Bile Pigments: Negative
Bile Salts: Negative
Urobilinogen: Present in normal amounts
Feces: Normal Coloured

19) A medical student recovering from an attack of influenza was noticed to be slightly
jaundiced. Worried that he might have hepatitis, the student had some biochemical tests
[Link] your Probable Diagnosis from the Following results.

Serum Bilirubin (Total): 3.8 mg/dL

Serum Bilirubin (Conjugated): 2.1 mg/dL
Serum Bilirubin (unconjugated): 1.7 mg/dL
Aspartate Amino Transferase: 282.0 U/L
Alanine Amino Transferase : 390.0 U/L
Serum Alkaline Phosphatase: 178.0 U/L
Urinary Findings:
Bile Pigments : +++
Bile Salts :+
Urobilinogen : Present
Feces : Normal Coloured

7
20) An elderly man was admitted to hospital with acute abdominal pain. Clinically, he had
generalized peritonitisandradiography suggested a perforated viscus. He underwent surgery for
this condition. Postoperatively 3 units of blood were transfused and he was noted to have slight
jaundice on the 7th postoperative day.
Give Your Probable Diagnosis from the following Biochemical Data.
Serum Bilirubin (Total): 5.0 mg/dL
Serum Bilirubin (Conjugated): 0.4 mg/dL
Serum Bilirubin (unconjugated): 4.6 mg/dL
Aspartate Amino Transferase: 15.0 U/L
Alanine Amino Transferase: 20.0 U/L
Serum Alkaline Phosphatase : 65.0 U/L
Urinary findings:
Bile Pigments: Negative
Bile Salts: Negative
Urobilinogen +++
Feces Dark Brown

21) A person was referred to the surgical OP with a three months history of epigastric pain,
radiating into the back and weight loss. He gave history passing dark
colored urine and pale stools.
Give Your Probable Diagnosis from the Following Biochemical Data
Serum Bilirubin (Total): 25.0 mg/dL
Serum Bilirubin (Conjugated): 20.0 mg/dL
Serum Bilirubin (unconjugated): 5.0 mg/dL
Aspartate Amino Transferase: 30.0 U/L
Alanine Amino Transferase: 40.0 U/L
Serum Alkaline Phosphatase: 950.0 U/L
Urinary Findings:
Bile Pigments: +++
Bile Salts: ++
Urobilinogen: Absent
Feces: Clay Coloured

22) The following are the laboratory data on the acid- base status of a patient admitted in a
hospital. Give your comments.
pH 7.4
PCO2 40 mm Hg
HCO3‾ 24 mmol/l
H2CO3 1.2 mmol/l
HCO 3 ‾ : H2CO3 20:1

8
23) The following are the laboratory data on the acid- base status of a patient admitted in a
hospital. Give your comments.
pH 7.55
PCO2 20 mm Hg
HCO3‾ 24 mmol/l
H2CO3 0.6 mmol/l
HCO 3 ‾: H2CO3 40: 1

24) The following are the laboratory data on the acid- base status of a patient admitted in a
hospital. Give your comments.
pH 7.55
PCO2 40 mm Hg
HCO3‾ 39 mmol/l
H2CO3 1.2 mmol/l
HCO 3 ‾: H2CO3 32.5: 1

25) The following are the laboratory data on the acid- base status of a patient admitted in a
hospital. Give your comments.

pH 7.2
PCO2 40 mm Hg
HCO3‾ 15 mmol/l
H2CO3 1.25 mmol/l
HCO 3 ‾: H2CO3 12: 1

26) The following are the laboratory data on the acid- base status of a patient admitted in a
hospital. Give your comments.

pH 7.2
PCO2 60 mm Hg
HCO3‾ 24 mmol/l
H2CO3 2.7 mmol/l
HCO 3 ‾: H2CO3 8.8: 1

27) The following are the laboratory data on the acid- base status of a patient admitted in a
hospital. Give your comments.

pH 7.42
PCO2 28.4 mm Hg
HCO3‾ 18.8 mmol/l
H2CO3 0.94 mmol/l
HCO 3 ‾: H2CO3 20: 1

9
28) The following are the laboratory data on the acid- base status of a patient admitted in a
hospital. Give your comments.
pH 7.43
PCO2 62 mm Hg
HCO3‾ 35 mmol/l
H2CO3 1.75 mmol/l
HCO 3 ‾: H2CO3 20: 1

29) A 53 years old male smoker was admitted to ICU of Hospital with history of chest pain. As
part of critical care work up, his acid base status was assessed.

Blood pH : 7.40
pCO2 : 40 mmHg
Plasma HCO3 : 25 mEq/L

30) As part of a class experiment in physiology, a medical student volunteered to have a sample
of blood taken. The demonstrator took some time to explain the procedure to the class, during
which time the student became increasingly anxious. As the blood was being drawn she
complained of tingling in her fingers and toes.
Give your opinion regarding the acid base status.
Blood pH : 7.55
pCO2 : 20 mmHg
Plasma HCO3 : 20 mEq/L
Total Ca2+ : 9.6 mg/dL

31) A 25 year old who was a known type I DM since the age of 12 years was admitted in a semi
conscious condition .On examination he was severely dehydrated. Pulse was rapid and
feeble .BP 90/70 mmHg. There was purulent discharge from the left ear. Arterial blood and
Urine sample drawn from patient showed the following results
Blood pH : 7.30
pCO2 : 29 mmHg
Plasma HCO3 : 14 mEq/L
Na+ : 130 meq/L
Cl- : 90 meq/L

32) A known asthmatic came for routine checkup. Give your opinion regarding the acid base
status of the patient from the following ABG data.
Blood pH : 7.30
pCO2 : 75 mmHg
Plasma HCO3 : 38 mEq/L

10
33) A 26 year old woman presented on a number of occasions for treatment of bulimia. This
admission followed several days of vomiting. Give your opinion regarding acid base status of the
patient.
Blood pH : 7.58
pCO2 : 47 mmHg
Plasma HCO3 : 42 mEq/L

34) Comment on the following laboratory findings reported in a patient complaining of acute
pain abdomen.
Serum :
Amylase 1400 [Link]
Calcium 6.8 mg/dl
Total proteins 6.0 g/dl
Glucose 460 mg/dl
Urine :
Sugar ++++

35) A 56-year-old businessman was admitted to the emergency department of the Government
General Hospital with complaints of severe retrosternal pain of 6 hours duration. He gave history
of heavy smoking and alcohol consumption for the past 25 years.
On examination, he was profusely sweating. His blood pressure was 160/100mmHg.
ECG showed S-T segment elevation. Blood sample was taken for biochemical analysis. What is
your diagnosis?
Serum CK 1160 U/L
Serum CK-MB 170 U/L
Serum AST 380 U/L
Serum LDH 970 U/L
Increase in LDH I isoenzyme fraction by 50%
Serum Uric acid 9 mg/dL

36) A 53-year-old man was brought to the ED with complaints of severe abdominal pain. The
pain had started about 18 hours before coming to the hospital. He gave history of heavy alcohol
intake over many years. He had no previous history of gastrointestinal diseases.
On examination, the patient was mildly shocked and his abdomen was tender in the
epigastric region with slight guarding. There was no evidence of either intestinal obstruction or
perforation of a viscus on radiological examination. His ECG was normal. Blood and Urine
samples were taken for biochemical analysis.
Serum Amylase 1500 U/L
Serum Lipase 3000 U/L
Plasma Glucose 380 mg/dL
Serum Total Calcium 6.0 mg/dL
Urine Sugar +++
Urinary Amylase 2000 U/L

11
37) A 56 year old chronic alcoholic was admitted for abdominal pain and distension. He was
emaciated and was noted to have [Link] following were the results of laboratory
investigation
Serum total Protein 5.5 gm/dL
Serum Albumin 1.8 gm/dL
Serum Globulin 3.7 gm/dL
His serum protein electrophoretic pattern is shown below
Interpret the results & findings

(-) (+)

38) A 61-year old man presented to the surgical OP with severe low back pain, loss of weight &
breathlessness. On examination he was anemic and there was tenderness over mid thoracic
vertebra.X-ray of chest & lumbar vertebra revealed punched out osteolytic lesions in ribs &
vertebral bodies.
The following were the results of laboratory investigation
Serum Calcium 11.2 mg/dL
Serum Phosphate 6 mg/dL
Serum Alkaline Phosphatase 95 IU / L
Serum Total Protein 9.5 gm/dL
Serum Albumin 3.2 gm/dL
Serum Globulin 6.3 gm/dL
Urine Bence Jones Protein + ve
Serum protein electrophoretic pattern is shown below

(-) (+)

12
39) A 13 year old boy presented with massive swelling of both legs and puffiness of face which
his mother said, was more soon after getting up from the bed in the morning. He gave history of
fever with throat pain and some skin lesions 2 months prior to this complaint. His urine output
has marginally reduced in the recent week
O/E He had bilateral pitting pedal oedema& swollen eyelids. He was mildly anemic and
his BP was 100/ 60 mmHg
The following were the results of laboratory investigation.
Blood urea 32 mg/dL
Serum Creatinine 0.6 mg/dL
S. Cholesterol 459 mg/dL
Serum Total Protein 4.8 gm/dL
Serum Albumin 2.5 gm/dL
Serum Globulin 2.3 gm/dL
Urine Protein +++ (by heat–acetic acid test)
24 –hour urine protein 3.1 gm/day
Serum protein electrophoretic pattern is shown above

(-) (+)

13