SAQ 2005 – Older patient with vomiting and abnormal blood gas

A 78-year-old woman presents after three days of nausea, vomiting, diarrhoea and malaise.

Her history includes atrial fibrillation, hypertension and type 2 diabetes. Her regular medicines are candesartan 16 mg daily, apixaban 2.5 mg twice daily, dapagliflozin 10 mg daily, lercanidipine 10 mg daily, bisoprolol 10 mg daily, simvastatin 40 mg daily, and linagliptin-metformin 2.5 mg/1 g twice daily.

She is alert and orientated, with a clear chest and a soft non-tender abdomen. Observations are BP 141/72 mmHg, HR 90/min, RR 28/min, SpO2 93% on room air and temperature 35.2 C.

Parameter	Result
FiO2	0.21
pH	6.75
pCO2	24 mmHg
pO2	86 mmHg
HCO3	3 mmol/L
Sodium	132 mmol/L
Potassium	6.4 mmol/L
Chloride	102 mmol/L
Glucose	15.7 mmol/L
Lactate	15.0 mmol/L
Urea	14.6 mmol/L
Creatinine	237 umol/L

Interpret the blood gas and biochemistry results, including relevant calculations.

(Marked out of 7.0)
</p> <table class="saq-prop-table"> <thead> <tr> <th>Abnormality</th> <th>Interpretation</th> </tr> </thead> <tbody> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> <tr> <td></td> <td></td> </tr> </tbody> </table> <p>

/ 7

State the most likely aetiologies for the dominant acid-base abnormality.

(Marked out of 1.0)

/ 1

List your management priorities, including doses or endpoints where relevant.

(Marked out of 4.0)

/ 4

Total Score: 0 / 12

Percentage: 0%