Question 1:
PH = 7.51, that is mild alkalaemia
PCO2 = 28, that is less than 40. So we have respiratory alkalosis.
Compensation for acute respiratory alkalosis: HCO3 drops by 2 mmol/L for every 10 mmHg decrease in pCO2 from 40mmHg. Accordingly, HCO3 should drop by (12 x 0.2) = 2.4, SO expected HCO3 is 21.6 (that is close to 23) so we have pure respiratory alkalosis.
51 year old man, recently returned from the middle east, presented with shortness of breath. His CXR was normal. His arterial blood gases showed the following:
PH = 7.51
PaCO2 = 28 mmHg
PO2 = 56 mmHg
Answers:
Hb = 115 g/L, that is mild anaemia. (Remember, anaemia happens when blood cells don’t have enough haemoglobin or there is not enough red blood cells).
RCC (red cells count) = 4.3, that is just within the normal range for men, towards the low side.
19 year-old-man recently returned from Sudan presented with fever.
His Bloods showed the following:
Hb = 115 g/L
RCC = 4.30
Hb = 83 g/L, that is moderate anaemia.
Anaemia happens when blood doesn’t have enough haemoglobin or red blood cells
Red cell count = 3.05, that is low.
Red cell count represent the number of red blood cells per microliter (mcL) of blood. Normal values are:
22 year-old-girl from african origin presented with severe chest pain. Her blood tests showed the following:
Haemoglobin = 83 g/L
Red Cell Count = 3.05
Question 1:
We should consider ascending cholangitis in any patient with fever and features of obstructive jaundice till prove otherwise.
The diagnosis of ascending cholangitis is a clinical diagnosis. Patients usually have the classic Charcot triad of abdominal pain, fever, and jaundice.
75 year old lady presented to the emergency department after a fall. In ED she was found to be slightly febrile with blood pressure of 95/55. Part of the investigation performed was LFT and it showed the following:
Bilirubin = 101 umol/L (< 16)
Question 1:
PH = 7.599 That is moderate alkalaemia (very close to the severe range – Moderate alkalaemia is PH between 7.5 – 7.6. Severe alkalaemia is PH > 7.6).
PCO2 = 22 mmHg, that is low. So we have respiratory alkalosis.
Next step is compensation.
42 year old alcoholic man, with type 2 DM. Presented with alcohol withdrawal symptoms. His blood gas (VBG) showed the following:
PH = 7.599
PCO2 = 22 mmHg