SAQ 1173 – Vomiting with electrolyte abnormalities and hypoglycaemia

Marked out of 8.00

A 65-year-old woman presents after 24 hours of refractory vomiting with moderate intermittent abdominal pain. She re-presents feeling more unwell after not waiting yesterday during severe access block. Her history includes hypothyroidism. Initial triage observations are temperature 35.6 degrees C, HR 70/min, BP 105/50 with a 25 mmHg postural drop, RR 24/min and SpO2 99% on room air. Blood results are shown below.

Test Result Reference range
Hb 154 g/L 110-165
WCC 13.3 x 10^9/L 3.5-11
Platelets 239 x 10^9/L 140-400
Na 126 mmol/L 135-145
K 6.1 mmol/L 3.5-4.5
Cl 101 mmol/L 100-110
HCO3 19 mmol/L 22-33
Urea 12.2 mmol/L 3-8
Creatinine 85 micromol/L 50-100
Calcium (total) 2.39 mmol/L 2.15-2.6
Albumin 40 g/L 33-47
Glucose 3.2 mmol/L 4.0-7.8

List four (4) differential diagnoses in view of the blood results.

(Marked out of 4.0)


/ 4

List three (3) immediate management priorities.

(Marked out of 3.0)


/ 3

List one (1) blood test that may confirm an underlying endocrine diagnosis.

(Marked out of 1.0)


/ 1

Total Score: 0 / 8

Percentage: 0%