SAQ 278 – Metabolic – long lie with rhabdomyolysis and severe hyperkalaemia

Marked out of 12.00

An 86-year-old man is brought in after a fall and a 14-hour lie on the floor. He is shocked, hypothermic, hypoxic, drowsy, and in rapid atrial fibrillation. His blood results are shown below.

Test Result Reference range
pH 7.28 7.35-7.45
pCO2 45 mmHg 40-50
HCO3 11 mmol/L 24-32
Base excess -6 -3 to +3
Sodium 141 mmol/L 135-145
Potassium 7.9 mmol/L 3.5-5.1
Chloride 109 mmol/L 95-110
Glucose 8.8 mmol/L 3.5-7.8
Lactate 3.4 mmol/L 0.6-2.4
Haemoglobin 192 g/L 135-175
Creatinine 180 micromol/L 44-97
CK 18,415 IU/L <180
CRP 178 mg/L <5

List the four (4) most important diagnoses requiring treatment.

(Marked out of 4.0)


/ 4

State four (4) blood-test findings that support these diagnoses.

(Marked out of 4.0)


/ 4

State two (2) potential benefits and two (2) adverse effects of sodium bicarbonate in this case.

(Marked out of 4.0)


/ 4

Total Score: 0 / 12

Percentage: 0%

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