Lab Case 90

A 70 year old man presents to ED with weakness, vomiting and central abdominal pain

Vital signs:

BP 140/90

PR 110/min

Temp  36 degrees

Blood tests:

pH  7.40  (7.3-7.44)

pCO2  56  (35-45 mmHg)

HCO3  34  (222-26  mmol/l)

BE  7

Sodium  135  (137-145  mmol/l)

Potassium  3.8  (3.5-5  mmol/l)

Chloride  90  (99-111  mmol/l)

Lactate  2.3  (<2  mmol/l)

Urea  11.6  (3-8  mmol/l)

Creat  125  (40-120  umol/l)

Bilirubin  23  (<21 umol/l)

GGT  117  (<51 U/L)

ALT  36  (<36 g/l)

ALP  61  (35-110  U/L)

Questions

  1. Describe and interpret 3 significant abnormalities in the blood gas
  2. List and interpret two other abnormailities
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One thought on “Lab Case 90

  1. Metabolic alkalosis & hypochloremia 2o to vomiting
    Respiratory acidosis, appropriately compensated (57 calculated)
    Mild renal impairment, possibly prerenal 2o to dehydration (vomiting &tachycardic)
    GGT ALP and bilirubin all slightly elevated. In elderly pt with vomiting & abdo pain, raises possibility of lesion obstructing cbd eg ca of pancreas /choledochocarcinoma; along with stone, need excluding with US.
    Note also hyperlactaemia

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