Lab Case of the Week 24th Feb 2021

A 26-year-old man presents with abdominal pain and vomiting. He drinks alcohol regularly and smokes marijuana. On examination, there is epigastric tenderness with guarding. Vitals: BP 100/60, PR 100/min, T 37.5

His VBG:pH  7.47

pCO2  66  mmHg

HCO3  47  mmol/l

BE  19

Na  131  mmol/l

K  2.9  mmol/l

Chloride  80  mmol/l

Creatinine  321  umol/l

Glucose  6.8  mmol/l

Lactate  1.8  mmol/l

Describe and interpret the blood gas

What is your differential diagnosis?