A 78-year-old woman presents to ED after three days of lethargy, fever, dysuria, and right flank pain. Her history includes type 2 diabetes mellitus, congestive cardiac failure, and hypertension. Her blood results are shown.
| Test |
Result |
Reference range |
| Na |
119 mmol/L |
135-145 |
| K |
8.4 mmol/L |
3.5-4.5 |
| Cl |
82 mmol/L |
100-110 |
| HCO3 |
6 mmol/L |
22-32 |
| Glucose |
66.6 mmol/L |
3.0-7.8 |
| Urea |
15.7 mmol/L |
3.1-7.1 |
| Creatinine |
298 umol/L |
70-120 |
Explain the HCO3 abnormality, including a relevant formula.
(Marked out of 3.0)
/ 3
Explain the glucose abnormality.
(Marked out of 1.0)
/ 1
Explain the sodium abnormality, including a relevant formula.
(Marked out of 2.0)
/ 2
Explain the potassium abnormality.
(Marked out of 1.0)
/ 1
Explain the urea and creatinine abnormalities, including any relevant formula or ratio.
(Marked out of 2.0)
/ 2
Her observations and ECG findings are shown below. State six steps in your management.
(Marked out of 6.0)
| Observation |
Value |
| GCS |
13 (E3 V4 M6) |
| Pulse |
120/min |
| Blood pressure |
95/55 mmHg |
| Temperature |
38.9 degrees C |
| Respiratory rate |
20/min |
| Oxygen saturation |
99% on room air |
| Abdomen |
Soft, with right renal angle tenderness |
| ECG |
Sinus tachycardia with tall peaked T waves and broad QRS complexes |
/ 6
Total Score: 0 / 15
Percentage: 0%
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