In class during the case history David has mentioned that you can look for signs in the blook to know if the person has hypo vs hyper. and that age can be a key as well since typically only young people have hyper. A 14 year old female is going next Monday for an endoscope, because she has really bad acid reflux and it feels like her food is getting stuck on the way down. she is currently taking Pepcid to help with eating and not chocking. When looking at the blood work the following would indicate if the acid reflux is from hypochloridria elevated chloride >106 elevated BUN >16 total protein <6.9 MCV >89.9 albumin <4 calcium <9.2 ALK-FOS < 70 if the blood work does not follow this pattern do you then think Hyper? or could allergies or something else be the issue? Is there a pattern to look for if someone has hyperchloridria?

David said: If the blood work does not follow this pattern do you then think Hyper? Yes. or could allergies or something else be the issue? Stress can make it worse, so can diet, smoking. Is there a pattern to look for if someone has hyperchloridria? Red tongue, little or no gas, red gums, aphthous stomatitis, possible increased eosinophils.