Lab Case 47

A 70 year old man presents to your ED feeling unwell with abdominal pain and vomiting for two days. He has a history of NIDDM, HTN and high Cholesterol. He is immediately triaged to your resuscitation bay, placed on 15 litres oxygen by non rebreather mask and iv access is obtained.

Vitals:

BP = 160/50

PR 115/min

T 37.5 Celsius

RR 40/min

His ABG and blood results are as follows Continue reading

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Lab Case 46

A 70 year old man presents after feeling acutely unwell a few hours ago. He complains of weakness, lethargy and a painful knee. On examination he is diaphoretic and looks unwell.

He is currently on treatment for diabetes, heart failure, AF, HTN

Vitals:

BP 160/50

PR 50/min

RR 22/min

T 36 celsius

His blood results are as follows: Continue reading

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Lab Case 45

An 80 year old male presents from home with 2 days of worsening of shortness of breath. He has a history of chronic airways disease and was recently hospitalised for repair of an Internal Iliac artery aneurysm.

Vital Signs:

BP 160/60 mmHg

PR 88/min

RR 26/min

Saturations 95% RA

An ABG was performed: Continue reading

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Lab Case 44 – Interpretation

1.

High anion gap metabolic acidosis – renal failure, possible sepsis (lactate and ketones not given). Delta gap =1, pure high anion gap metabolic acidosis

Acute on chronic renal failure with moderate to severe hyperkalaemia secondary to possible acute blood loss (??GI – low Hct, low Hb, high platelets), infection, dehydration

Microcytic hypochromic anaemia – chronic blood loss, Fe deficiency, renal failure (however expect anaemia of chronic disease to be normocytic, normochromic)

2.

ECG changes – tall T waves, flattening of P waves, some early lengthening of the PR interval. Possible ischaemia as cause of presentation

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