Lab case 439

61-year-old man presented to ED with hypoglycemia that was difficult to correct with oral and IV dextrose. His venous blood gases showed the following.

PH = 7.30

PCO2 = 33   mmol/L

HCO3 = 16 mmol/L

Na = 127 mmol/L

K = 5.8 mmol/L

Cl = 100 mmol/L

Lactate = 2.8 mmol/L

Glucose = 2.8 mmol/L

Cr = 83 umol/L

 

Questions:

  1. Interpret these blood gases and what are the possible causes of these changes?
  2. What is the mechanism of hypoglycemia and how do you correct it?
  3. what is the differential diagnosis of hypoglycemia in non-diabetic patient?