Lab Case 139

A 27 year old female presents to your ED with a 2 day history of sore throat, cough and fevers. She has a history of “endocrine problems/ auto immune disease” and is on insulin and thyroxine. She also has Coeliac disease.

Vitals:

T 37.7

PR 130/min

BP 105/50

Her blood results:pH 7.357

pCO2 38.6mmHg

HCO3 21 mmol/l

BE -3.5

Na 128 mmol/l

K 5.5 mmol/l

Cl 93 mmol/l

Glu 19.3 mmol/l

Lactate 2.3 mmol/l

Urea 7.4 mmol/l

Creat 134 umol/l

Describe and interpret the blood results

Give a reasonable differential diagnosis

How would you treat her?