An 82 year old female is brought to your ED by ambulance which was called when the patients daughter noted that she was confused and hot.

The patient complains of abdominal pain and nausea.

Vitals:

BP 90/60

PR 110/min

T 38 degrees celcius

Blood results:

Na 138  (137-145 mmol/l)

K  4.1   (3.5-5 mmol/l)

Cl  101  (99-111 mmol/l)

Urea  7  (3-8 mmol/l)

Creatinine  46  (30-100 umol/l)

Hb  147  (110-155  g/l)

Platelets  333  (140-400)

WCC  17.7  (4-11 /l)

N  15.4  (1.8-7.5)

Bilirubin  39  (<16 umol/l)

ALP  156  (30-115 U/L)

GGT  603  (<36 U/L)

ALT  188  (<31  U/L)

ALB  46  (36-48  g/l)

Lipase 31 (13-60 IU/L)

CRP  14  (<5 mg/l)

Questions:

1. Describe 3 important features of the blood results
2. Give the likely diagnosis with a suitable explanation
3. What 5 questions are important on history?
4. Give three most likely causes
5. List 5 important management principles
6. What 3 features in this patient indicate a poor prognosis?
7. What are the 3 most common organisms involved?