SAQ 1012 – Toxicology – chronic cannabis use with vomiting and abnormal electrolytes

A 35-year-old woman with chronic marijuana use presents with 36 hours of intractable vomiting. She appears dehydrated, has mild abdominal distension without significant tenderness, is moderately drowsy, and continues to vomit with abdominal pain in ED.

She has no other past history. Her blood results are shown.

Test	Result
Sodium	110 mmol/L
Potassium	4.2 mmol/L
Chloride	75 mmol/L
Bicarbonate	29 mmol/L
Urea	42.5 mmol/L
Creatinine	320 micromol/L
WCC	17.5 x 10^9/L
Haemoglobin	160 g/L
Platelets	393 x 10^9/L
BSL	5.6 mmol/L
Beta-hCG	Negative

Describe and interpret the blood test abnormalities.

(Marked out of 3.0)

/ 3

Assuming the vomiting is due to cannabinoid hyperemesis syndrome, outline treatment options.

(Marked out of 4.0)

/ 4

Complete the table comparing acute moderate hyponatraemia with acute severe hyponatraemia.

(Marked out of 4.0)
</p> <table class="saq-prop-table" style="width: 100%; max-width: 100%; table-layout: fixed; border-collapse: collapse;"> <thead> <tr> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Degree of severity</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Moderate</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Severe</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Clinical features</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Serum sodium (mmol/L)</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

/ 4

Briefly describe your immediate treatment of her acute hyponatraemia.

(Marked out of 4.0)

/ 4

Total Score: 0 / 15

Percentage: 0%