One of my nurses who was usually in good health developed chronic complaints. She felt tired all the time and had a variety of aches and pains. She has been going through menopause for a long time but this set of problems seem different. Then she broke her arm after sustaining a minor fall. An investigation was in order. I should order some tests, but which ones?

Anemia would explain the fatigue so a CBC was a no brainer. With the surprise fracture, I wanted to cast the net wider, so I ordered a comprehensive metabolic panel.

This is an automated test that was a good value for the amount of information provided, I thought.

Nobody was more surprised than I when the test provided results that were the key to her very rare diagnosis. Her serum CALCIUM was very high, and her alkaline phosphatase was also elevated.

Further evaluation showed her diagnosis to be PRIMARY HYPERPARATHYROIDISM.

Removal of her abnormal parathyroid gland was curative. I have been a big fan of the Comprehensive Metabolic  Panel ever since.

The Panel of 14 tests includes:

• Glucose – an essential test to check in Diabetes, Seizures and Coma.
• Sodium, Potassium, Chloride, and CO2 and the associated Anion Gap – can be abnormal in a variety of accidents, and other conditions.
• BUN and Creatinine – cleared by the kidneys, and become elevated in Renal, or Kidney conditions.
• Calcium and alkaline phosphatase – reflect bone metabolism, and are sensitive to Vitamin D and parathyroid hormone, as in my nurses case.
• Albumin and Globulin – important blood proteins. Globulins contain the   important immunoglobulins. A variety of conditions will influence their values.
• AST (SGOT) and ALT – elevated in liver disease

Type in “Comprehensive Metabolic Panel” in google, and choose from the variety of “hits” to get more information about this “ Sherlock Holmes’ Magnifying Glass” for Physicians.

Medicine would be hard pressed to do without it!

Dr. C.