SAQ 263 – Toxicology – high anion-gap acidosis with osmolar gap

Marked out of 12.00

A 23-year-old man with a decreased level of consciousness is being assessed. His arterial blood gas and laboratory results are shown below.

Test Result Reference range
FiO2 0.30
pH 6.9 7.35-7.45
pCO2 10 mmHg 37-45
pO2 147 mmHg 80-95
Bicarbonate 2 mmol/L 22-28
Base excess -30 -3 to +3
O2 saturation 98% >95
Lactate 7.1 mmol/L <1.3
Sodium 140 mmol/L 134-146
Potassium 6.0 mmol/L 3.4-5.0
Chloride 105 mmol/L 98-106
Creatinine 0.1 mmol/L 0.06-0.12
Urea 4.8 mmol/L 3.0-8.0
Glucose 5.2 mmol/L 3.5-5.5
Measured osmolality 360 mOsm/L 275-295

Provide four (4) calculations that assist interpretation of these results.

(Marked out of 4.0)


/ 4

Using the scenario and calculated values, list three (3) likely causes.

(Marked out of 3.0)


/ 3

State two (2) advantages and three (3) disadvantages of bicarbonate therapy in this patient.

(Marked out of 5.0)


/ 5


Total Score: 0 / 12

Percentage: 0%