SAQ 1378 – Elderly patient with fever and metabolic abnormalities

Marked out of 15.00

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%