SAQ 1169 – Abdominal pain, shock and abnormal blood results

A 47-year-old man presents to ED with 3 days of abdominal pain and vomiting. He has hypertension and type 2 diabetes mellitus and reports no smoking or alcohol use. Vital signs are temperature 38.1 degrees C, HR 118/min, BP 88/60, RR 14/min and SpO2 96% on room air. His blood results are shown below.

Test	Result	Reference range
Na	138 mmol/L	135-145
K	4.2 mmol/L	3.2-5.0
Cl	105 mmol/L	95-110
HCO3	20 mmol/L	22-32
Urea	9.8 mmol/L	2.5-6.5
Creatinine	110 micromol/L	45-95
Bilirubin	163 micromol/L	<15
Protein	62 g/L	60-80
Albumin	31 g/L	35-50
ALT	302 U/L	<30
AST	236 U/L	<35
GGT	908 U/L	<35
ALP	972 U/L	30-110

List three (3) significant abnormalities in the blood results.

(Marked out of 3.0)

/ 3

State the most likely diagnosis from the information provided.

(Marked out of 1.0)

/ 1

State two (2) other diagnoses that could account for the presentation and blood tests.

(Marked out of 2.0)

/ 2

List and justify three (3) investigations you would perform.

(Marked out of 3.0)
Investigation | Justification<br /> 1. |<br /> 2. |<br /> 3. |

/ 3

List four (4) treatment priorities. For each, state your preferred intervention or medication, including dose.

(Marked out of 4.0)
Treatment priority | Intervention or drug and dose<br /> 1. |<br /> 2. |<br /> 3. |<br /> 4. |

/ 4

Total Score: 0 / 13

Percentage: 0%