A 39 year old previously well female presents to your ED with a 3 day history of abdominal pain and diarrhoea.

Vital Signs:

BP 100/60

PR 110/min

RR 26/min

Her initial blood tests:

FBC:

Hb 109  ( 135-170 g/l)

Platelets 213     ( 140 – 400 X 10^9/l )

WCC 24.4     ( 4-11 X10^9/l )

VBG :

pH 7.27

pCO2  42    ( 35 -45 mmHg)

HCO3   18   (24  mmol/l )

BE  -8

Na 145     (137-145 mmol/l )

K 1.9     (3.4 – 5.0 mmol/l )

Cl  115      ( 99-111 mmol/l)

Lipase 1050      (< 50)

1. What is the likely diagnosis?

2. List the three most common causes

3. Interpret the blood gas

4. Give two reasons for the hypokalaemia

5. What are indications for acute surgical intervention?