A 65-year-old woman presents after 24 hours of refractory vomiting with moderate intermittent abdominal pain. She re-presents feeling more unwell after not waiting yesterday during severe access block. Her history includes hypothyroidism. Initial triage observations are temperature 35.6 degrees C, HR 70/min, BP 105/50 with a 25 mmHg postural drop, RR 24/min and SpO2 99% on room air. Blood results are shown below.
| Test |
Result |
Reference range |
| Hb |
154 g/L |
110-165 |
| WCC |
13.3 x 10^9/L |
3.5-11 |
| Platelets |
239 x 10^9/L |
140-400 |
| Na |
126 mmol/L |
135-145 |
| K |
6.1 mmol/L |
3.5-4.5 |
| Cl |
101 mmol/L |
100-110 |
| HCO3 |
19 mmol/L |
22-33 |
| Urea |
12.2 mmol/L |
3-8 |
| Creatinine |
85 micromol/L |
50-100 |
| Calcium (total) |
2.39 mmol/L |
2.15-2.6 |
| Albumin |
40 g/L |
33-47 |
| Glucose |
3.2 mmol/L |
4.0-7.8 |
List four (4) differential diagnoses in view of the blood results.
(Marked out of 4.0)
/ 4
List three (3) immediate management priorities.
(Marked out of 3.0)
/ 3
List one (1) blood test that may confirm an underlying endocrine diagnosis.
(Marked out of 1.0)
/ 1
Total Score: 0 / 8
Percentage: 0%
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