SAQ 1726 – Older patient found collapsed with severe hyperglycaemia

An 85-year-old man with ischaemic heart disease, hypertension and type 2 diabetes is found on the floor. Initial biochemistry is shown below.

Test	Result	Reference range
Sodium	143 mmol/L	135-145
Potassium	5.3 mmol/L	3.5-5.1
Chloride	106 mmol/L	100-110
Bicarbonate	13 mmol/L	22-32
Urea	38.9 mmol/L	2.1-7.1
Creatinine	351 micromol/L	46-90
Glucose	52 mmol/L	3.0-7.8
Creatine kinase	145 U/L	34-145

State the most likely diagnosis.

(Marked out of 1.0)

/ 1

List four additional problems identified in the results and state the likely cause of each.

(Marked out of 8.0)

/ 8

Further assessment shows left foot cellulitis and the observations below. State four components of management.

(Marked out of 4.0)

Finding	Result
Left foot	Cellulitis
GCS	13 (E3 V4 M6)
Heart rate	140/min
Blood pressure	105/70 mmHg
Temperature	38.4 C

/ 4

List five additional investigations and justify each.

(Marked out of 5.0)

/ 5

Total Score: 0 / 18

Percentage: 0%