39 year old IDDM, presents with a 1 day history of vomiting. The patient has been on an alcohol binge and non-compliant with his insulin.
80 year old male known diabetic, re-presents to ED after a recent admission in which the patient was diagnosed with pulmonary TB.
66 year old female presents complaining of anuria for the past 48 hours. She reports nausea and vomiting over the last week. She has a background history of IHD, having undergone a CABG 6 weeks ago. She also has Type 2 DM on Metformin and Gliclazide. The patient baseline Cr is 150umol/l
ABG on FiO2 0.4
pH 6.941 Na 139 mmol/l
pCO2 9.5 mmHg K 5.7mmol/l
pO2 168mmHg Cl 105mmol/l
HCO3 1.9mmol/l Glu 5.5 mmol/l
B/E -29.3 Cr 659 umol/l
Lactate 18 mmol/l Hb 94g/l
- Describe and Interpret the ABG
- Name the types of lactic acidosis and give examples of each.
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
A 57 year old lady presents to your ED with abdominal pain, shortness of breath and vomiting for 1 day. She has reduced appetite and last ate 2 days ago.
She has high cholesterol and type II DM and is taking a statin and Jardiamet. Continue reading
25 year old male with a background of quadriplegia (from previous motor MVA), presents to ED with altered level of consciousness. He has recently undergone surgery on him lower limbs to release strictures. The patient is not known to be diabetic.
55 Year old female presents with a 1 week history of diarrhoea and vomiting. She has recently been discharged from hospital after treatment of spontaneous bacterial peritonitis. She has a background of cirrhosis of the liver and diabetes on metformin+dapagliflozin combination. The patient has a needle phobia and was hyperventilating for some time prior to the insertion of the drip.
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
A 16 year old patient presents critically unwell with severe life threatening diabetic ketoacidosis, in severe shock Continue reading
A 32 year old Aboriginal woman presents to the ED with lethargy. She is previously well, and has not been seen by medical services for the previous 10 years.
Her VBG reveals: Continue reading