A 68-year-old woman presents after 5 days of vomiting. She is now lethargic, unable to get out of bed, and unable to walk. She has no fever, diarrhoea, or abdominal pain. Her history includes polymyalgia rheumatica and osteoporosis, and medications include aspirin, prednisone, and alendronate. She is pale, drowsy, globally weak without focal neurology, cool peripherally, and dehydrated. After 1000 mL normal saline, her systolic BP remains in the 70s.
| Observation |
Value |
| Temperature |
35.9 C |
| Heart rate |
120/min |
| Blood pressure |
75/45 mmHg |
| Respiratory rate |
24/min |
| Oxygen saturation |
98% on room air |
| VBG parameter |
Result |
| pH |
7.28 |
| Na |
123 mmol/L |
| K |
3.5 mmol/L |
| Cl |
100 mmol/L |
| HCO3 |
16 mmol/L |
| Glucose |
2.2 mmol/L |
State the most likely diagnosis and give your rationale.
(Marked out of 3.0)
/ 3
List three (3) VBG components that help confirm the diagnosis.
(Marked out of 3.0)
/ 3
List five (5) key treatments.
(Marked out of 5.0)
/ 5
List one intervention that may prevent similar episodes in future.
(Marked out of 1.0)
/ 1
Total Score: 0 / 12
Percentage: 0%
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