SAQ 1578 – Alcohol-related vomiting with venous blood gas

Marked out of 13.00

A 45-year-old man with alcohol abuse presents with intractable vomiting. He is diaphoretic with epigastric tenderness. His venous blood gas is provided below.

Test	Result	Reference range
pH	7.61	7.35-7.45
pCO2	19 mmHg	35-45
HCO3	18 mmol/L	22-32
Sodium	137 mmol/L	135-145
Potassium	3.7 mmol/L	3.5-4.2
Chloride	98 mmol/L	95-110
Ionised calcium	1.03 mmol/L	1.15-1.32
Glucose	4.8 mmol/L	3.0-7.8
Lactate	8.5 mmol/L	0.5-2.2

State your interpretation of the respiratory acid-base status and list three differential diagnoses.

(Marked out of 4.0)

/ 4

State your interpretation of the metabolic acid-base status, show supporting calculations, and list two differential diagnoses.

(Marked out of 5.0)

/ 5

List four other investigations and provide justification for each.

(Marked out of 4.0)

/ 4

Total Score: 0 / 13

Percentage: 0%