# Lab case 440

80-year-old lady presented with confusion. Her Venous blood gases showed the following:

PH = 7.396

pCO2 = 52 mmHg

# Lab case 439 Interpretation

Question 1:

PH = 7.30 that is mild acidaemia.

HCO3 = 16 mmol/L (>24) so we have metabolic acidosis.

Next, we need to calculate the anion gap and the compensation (using Winter’s formula)

# Lab case 439

61-year-old man presented to ED with hypoglycemia that was difficult to correct with oral and IV dextrose. His venous blood gases showed the following.

PH = 7.30

PCO2 = 33   mmol/L

# Lab case 438 Interpretation

PH = 7.39, that is within normal range/

pCO2 = 48 mmHg, that is slightly elevated (Can be considered normal for venous blood)

HCO3 = 29 mmol/L. That is high (Normal value is 24 mmol/L), SO, we have metabolic alkalosis.

# Lab case 438

80 year old lady with type 2 DM was referred for high blood sugar. Her blood gases showed the following:

PH = 7.39

pCO2 = 48 mmol/L

# Lab case 437 interpretation

PH = 7.34, that is very mild acidaemia.

HCO3 = 14 mmol/L. So, we have metabolic acidosis.

Next we need to calculate Anion Gap and compensation.

# Lab case 437

A police recruit doing a 20 km pack hike. Collapsed. GCS on arrival was 7. His temperature was 39.2 on arrival. His venous blood gases showed the following:

PH = 7.34

pCO2 = 27 mmHg

# Lab case 436 interpretation

PH = 7.391, that is within the normal range, slightly to the acidic side.

pCO2 = 57 mmHg, that is high. So we have respiratory acidosis.

It is not clear from the history if the condition is acute or chronic. Accordingly we are going to check for both.

# ECG case for the 24th of January 2024

71 y old male is coming with palpitations, haemodynamically stable.

# Answers for ECG case for the 17th of January 2024

This ECG represents fever induced Brugada syndrome.

Needs aggressive treatment of the fever and Cardiology referral for ICD.