Mike L., a 47-year-old man, went to his physician for an annualphysical that had been postponed for over 3 years. He had startedhis own business 4 years ago and had been extremely busy getting itestablished. Mike’s medical history indicated he was a nonsmoker,and his father and grandfather had histories of myocardialinfarctions before age 55. Since she had not seen this patient in anumber of years, the physician decided to order routine screeningtests.

CHEMISTRY RESULTS:

Test	Patient Results	Reference Range
Sodium	143	136-145 mEq/L
Potassium	4.6	3.6-5.0 mEq/L
Chloride	104	101-111 mEq/L
CO2	29.0	24.0-34.0 mEq/L
Glucose	95	80-120 mg/dL
BUN	19	7-24 mg/dL
Creatinine	1.0	0.5-1.2 mg/dL
Bilirubin Total	0.5	0.2-1.2 mg/dL
AST	35	5-40 IU/L
ALP	70	30-157 IU/L
Total Protein	7.5	6.0-8.4 g/dL
Albumin	4.6	3.5-5.0 g/dL
Calcuim	8.5	8.5-10.5 mg/dL
Cholesterol	305	<200 mg/dL

URINALYSIS:

Macroscopic	Patient Results	Reference Range
Color	Yellow	Colorless to amber
Appearance	Clear	Clear
Specific Gravity	1.014	1.001-1.035
pH	6.0	5-7
Protein	Neg	Neg
Glucose	Neg	Neg
Ketones	Neg	Neg
Bilirubin	Neg	Neg
Blood	Neg	Neg
Urobilinogen	Normal	Normal
Macroscopic
Nitrite	Neg	Neg
Leukocyte esterase	Neg	Neg

1. Indicate the abnormal results

2. Which conditions listed for question 2 can the physician ruleout with Mike’s medical history, physical examination, and currentlaboratory results?

3. What is the most probable cause of the abnormal result inthis patient.