SAQ 1022 – Renal – weakness with abnormal blood gas and POCUS

An elderly man self-presents with two weeks of increasing nausea, weakness and urinary frequency. Observations: HR 98/min, BP 105/80 mmHg, afebrile, RR 22/min and SpO2 100% on room air.

The junior doctor shows you the venous blood gas and renal POCUS images.

What is your initial treatment, including doses?

(Marked out of 6.0)
</p> <table class="saq-prop-table" style="width: 100%; max-width: 100%; table-layout: fixed; border-collapse: collapse;"> <thead> <tr> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Initial treatment</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Dose</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

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List your initial ED investigations other than bedside renal ultrasound and provide a rationale for each.

(Marked out of 4.0)

Parameter	Result	Reference range
pH	7.10	7.30-7.40
pCO2	32 mmHg	40-50
pO2	61 mmHg	–
HCO3	16 mmol/L	22-26
Sodium	133 mmol/L	136-146
Potassium	7.8 mmol/L	3.7-4.7
Glucose	5.3 mmol/L	3.5-5.4
Lactate	2.5 mmol/L	<2
Creatinine	682 micromol/L	60-110

</p> <table class="saq-prop-table" style="width: 100%; max-width: 100%; table-layout: fixed; border-collapse: collapse;"> <thead> <tr> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">ED investigation</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Rationale</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

/ 4

What is your interpretation of the POCUS?

(Marked out of 2.0)

/ 2

What are your next management steps?

(Marked out of 3.0)

/ 3

Total Score: 0 / 15

Percentage: 0%