A 44 year old FIFO (ex Mozambique) presents with a 1 month history of feeling generally unwell, abdominal cramps and diarrhoea.

On examination he is pale and sweaty with vital signs of

T 40 degrees Celsius

HR 130/min

BP 110/65

These are his blood results:

Hb 99  (135-170 g/l)

Plt 123  (240-400)

WCC 4.9  (4-11),  N 3.5, L 1.0, E 0

INR 1.2

PTT 32  (24-34 sec)

Na 131  (137-145 mmol/l)

Urea 18.3  (3-7 mmol/l)

Creat 229  (40-120 umol/l)

HCO3  19  (24 mmol/l)

1. Describe the abnormalities (3)

2. Give 5 suitable differential diagnosis (2)

3. what is the single most likely diagnosis? (1)

4. What are you emergent priorities? (3)

5. List 3 compications (1)

Thank you to Ed for this great case