SAQ 544 – Metabolic – mixed acid-base disturbance in respiratory distress

Review Completed

Marked out of 19.00

A 75-year-old man is brought to the ED with respiratory distress, fever and confusion. He is confused and combative. His observations and arterial blood gas are shown below.

Observation	Result
Temperature	38.7 C
Heart rate	120/min irregular
BP	110/60 mmHg
Respiratory rate	32/min
SpO2	91% on high-flow nasal prong oxygen
pH	7.21
pCO2	64 mmHg
pO2	75 mmHg
HCO3	21 mmol/L
Base excess	-6 mmol/L
Sodium	148 mmol/L
Chloride	105 mmol/L

Assuming potassium is normally 4.0 mmol/L, calculate the expected potassium and delta ratio, showing your calculations.

(Marked out of 2.0)

/ 2

State the acid-base abnormality and justify your answer.

(Marked out of 2.0)

/ 2

List three (3) key differential diagnoses. For each, list two investigations and justify each investigation.

(Marked out of 15.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Differential</th> <th>Investigation</th> <th>Justification</th> </tr> </thead> <tbody> <tr> <td>1a.</td> <td></td> <td></td> </tr> <tr> <td>1b.</td> <td></td> <td></td> </tr> <tr> <td>2a.</td> <td></td> <td></td> </tr> <tr> <td>2b.</td> <td></td> <td></td> </tr> <tr> <td>3a.</td> <td></td> <td></td> </tr> <tr> <td>3b.</td> <td></td> <td></td> </tr> </tbody> </table> <p>

/ 15

Total Score: 0 / 19

Percentage: 0%

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