Reference Range. Ionized calcium binds to negatively charged sites on protein molecules, competing with hydrogen ions for the same binding sites on albumin and other calcium-binding proteins. This binding is pH dependent and alters the level of ionized calcium in the blood.An increase in pH, alkalosis, promotes increased protein binding, which decreases free calcium levels.onized calcium is interpreted in conjunction with the total serum calcium measurement. An ionized calcium value within the reference range implies adequate calcium homeostasis, as this is a direct measure of calcium in its active form.
Acute hepatic necrosis. Drug induced liver injury can resemble an acute ischemic or toxic injury to the liver with rapid onset of hepatocellular injury and marked elevations in serum ALT and just as rapid decline once the agent is stopped.rug induced liver injury can resemble acute viral hepatitis with prominence of hepatocellular injury and marked elevations in serum ALT. Symptoms may also be identical those of viral hepatitis, with a prodomal period of fatigue, nausea and poor appetite followed by abdominal discomfort, dark urine and jaundice.
acute pyogenic arthritis, an acute bacterial infection of one or more joints, caused by trauma or a penetrating wound and occurring most frequently in children. Typical signs are pain, redness, and swelling in the affected joint; muscular spasms in the area; chills; fever; sweating; and leukocytosis. Treatment consists of immobilization of the joint, analgesia, sedation, and IV administration of an antibiotic. If required, the joint may be irrigated with normal saline solution and an antibiotic. Hospitalization is usually required. Also called acute septic arthritis.