A 38-year-old man with alcohol dependence presents with altered mental status and cannot provide a useful history. His vital signs and arterial blood gas are shown below.
| Observation |
Result |
| BP |
102/58 mmHg |
| HR |
104 bpm |
| RR |
28 /min |
| O2 saturation |
96% room air |
| Temperature |
34.5 degrees C |
| pH |
7.16 (7.35-7.45) |
| pCO2 |
21 mmHg (35-45) |
| HCO3 |
9 mmol/L (22-26) |
| Base excess |
-25 (-1 to 1) |
| Lactate |
8.2 mmol/L (0-2) |
| Glucose |
4.6 mmol/L (3-6.5) |
| Na |
140 mmol/L (135-145) |
| K |
6.0 mmol/L (3.5-5.0) |
| Urea |
9.0 mmol/L (4.0-8.0) |
| Ionised calcium |
0.7 mmol/L (1.15-1.35) |
| Osmolarity |
306 mOsm/kg (275-295) |
Provide two (2) calculations to assist with interpretation of these investigations.
(Marked out of 2.0)
/ 2
State the primary acid-base disturbance.
(Marked out of 1.0)
/ 1
List three (3) likely differential diagnoses for his presentation.
(Marked out of 3.0)
/ 3
List three (3) additional blood tests that are critically important in his workup.
(Marked out of 3.0)
/ 3
List three (3) specific treatments you would consider.
(Marked out of 3.0)
/ 3
Total Score: 0 / 12
Percentage: 0%
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