A 6 year old child is brought to ED by his mum, who states that the child has been unwell with fevers,vomiting, loin pain and low backache.

BP 70/40 mmHg

PR  120/min

Temp 38 degrees

RR 36/min

His blood gas shows:

pH  7.26   (7.36-7.44)

pCO2  32  (35-45 mmHg)

HCO3  14  (22-26 mmol/l)

BE  -12

Sodium  138  (137-145 mmol/l)

Potassium  5.0  (3.5-5 mmol/l)

Chloride  105  (99-111 mmol/l)

Creatinine  32  (<130umol/l)

Glucose  4.1  (4-6 mmol/l)

Lactate  1.2  (<1.5 mmol/l)

ketones +++

Questions:

1. Describe 5 abnormalities
2. What are 3 relevant negatives and significance?
3. Interpret your findings