SAQ 182 – Renal – high anion gap acidosis with severe hyperkalaemia

A 67-year-old man with no significant past history and no regular medications presents with one week of increasing dyspnoea and unsteadiness. Selected serum biochemistry is shown below.

Test	Result	Reference range
Sodium	145 mmol/L	134-146
Potassium	8.0 mmol/L	3.4-5.0
Chloride	107 mmol/L	98-106
Bicarbonate	5 mmol/L	22-28
Urea	63.2 mmol/L	2.5-6.4
Creatinine	3.40 mmol/L	0.05-0.1

Provide one (1) calculation that assists interpretation of these results.

(Marked out of 1.0)

/ 1

Interpret these results in this clinical setting. State three (3) points.

(Marked out of 3.0)

/ 3

List two (2) likely differential diagnoses for the cause of these results.

(Marked out of 2.0)

/ 2

Complete the table with three (3) urgent key investigations and one justification for each.

(Marked out of 6.0)

Investigation	Justification
1.
2.
3.

/ 6

Total Score: 0 / 12

Percentage: 0%