Lab Case 202

A 68 year old female is brought to ED by ambulance. her husband found her this morning confused and called the ambulance. He had last seen her last night before bed when she was well.

PMH – HTN, NIDDM

She takes propranolol, metformin, gliclazide, SGLT 2 inhibitor for diabetes

In ED the patient was obtunded Continue reading

Lab Case 159

A 60 year old male presents with 1 week history of vomiting. In the last 24 hours the family noted that he was confused and poor to respond. Background – IHD, HTN, NIDDM on Metformin, Coversyl, aspirin, metoprolol.

On arrival he was confused.

Vitals: BP  80/40   HR 46/min   Temp  34   RR 24/min and GCS 10 Continue reading

Lab case 157

A 34 year old woman is brought to ED by ambulance. She is travelling WA with her partner, who witnessed her lose consciousness, bite her tongue and experience jerking of her arms and extended legs for 2 minutes, followed by a period of confusion. she was back to normal within 20 minutes. Continue reading

Lab Case 148

A 49 year old man with NIDDM on Metformin is brought to the ED by his father. He was not seen for 2 days, father went to check on him and found him lying on the floor, confused and incoherent.

On arrival he was confused, not cooperative and looked unwell.

Vital Signs:

BP 90/60

PR 130/min

T 32

RR 30/min

His blood tests: Continue reading

Lab Case 146

An 85 year old female with bowel obstruction is in your Emergency department for the past 12 hours waiting for a bed. She has been seen by the general surgical team and accepted for admission. She has been having increasing pain and abdominal distension requiring opiate analgesics. The nurse has interrupted you on multiple occasions because the patient is becoming increasingly tired and breathless with some mild confusion. You are slightly annoyed by this and finally decide to see the patient. You find the patient looking unwell, on 4 litres oxygen in you short stay ward. You decide to move the patient to the resuscitation area and do “blood tests”

Her ABG shows: Continue reading