A 40-year-old homeless man is brought to the ED with altered conscious state and vomiting.
He has insulin-dependent diabetes mellitus. Arterial blood gas and biochemistry results are shown.
| Observation |
Value |
| HR |
120 bpm |
| BP |
85/55 mmHg |
| RR |
26/min |
| O2 saturation |
99% on room air |
| Temperature |
38.9 C |
| GCS |
10/15 (E2 V3 M5) |
Arterial blood gas on room air
| Test |
Result (ref) |
| pH |
7.31 (7.35-7.45) |
| pO2 |
70 mmHg (75-100) |
| pCO2 |
56 mmHg (35-45) |
| O2 saturation |
90% (95-100) |
| Bicarbonate |
16 mmol/L (22.0-30.0) |
| Base excess |
-5 (-3 to +3) |
Biochemistry
| Test |
Result (ref) |
| Na+ |
148 mmol/L (135-145) |
| K+ |
3.0 mmol/L (3.5-4.5) |
| Cl- |
112 mmol/L (95-110) |
| Glucose |
35 mmol/L (3.6-7.7) |
| Urea |
19 mmol/L (3.0-11.0) |
| Creatinine |
150 umol/L (<90) |
| Lactate |
3.0 mmol/L (0.2-1.8) |
| Ketones |
<0.1 mmol/L (<0.1) |
Complete the table for the acid-base abnormalities shown, listing the likely causes.
(Marked out of 8.0)
/ 8
State two (2) calculations you would apply to these results to assist assessment and management.
(Marked out of 2.0)
/ 2
List three (3) other abnormalities demonstrated in these pathology results.
(Marked out of 3.0)
/ 3
Outline four (4) principles of your fluid management strategy.
(Marked out of 4.0)
/ 4
There is no clear focal source of sepsis. List three (3) antibiotic choices for this patient.
(Marked out of 3.0)
/ 3
Total Score: 0 / 20
Percentage: 0%
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