17-year-old boy with wrist fracture. This patient became blue during manipulation of the fracture under bier’s block anaesthetic effect.
Arterial blood gas was performed and it showed the following:
PH = 7.30
PCO2 = 28 mmHg
17-year-old boy with wrist fracture. This patient became blue during manipulation of the fracture under bier’s block anaesthetic effect.
Arterial blood gas was performed and it showed the following:
PH = 7.30
PCO2 = 28 mmHg
This VBG was from a young girl with sever gastroenteritis (Vomiting and diarrhoea) for 3 days.
PH = 7.52, that is moderate alkalaemia.
pCO2 = 21 mmHg. So, we have respiratory alkalosis.
Question 1:
PH = 7.299 that is moderate acidaemia (less than 7.3), however we can argue that is mild as it is just 0.001 less than the value for mild acidaemia – ultimately, it is not going to change the management for the patient.
pCO2 = 52 mmHg, so we have respiratory acidosis.
10-years-old asthmatic boy, presented with croupy cough and wheezy chest. His blood gases showed the following:
PH = 7.299
pCO2 = 52 mmHg
Question 1:
PH = 7.23, that is moderate acidaemia.
pCO2 = 62 mmHg, So we have respiratory acidosis, this can be acute or chronic.
87 year old man with history of COPD and type 2 DM on insulin and metformin, was found unconscious. His VBG showed the following.
PH = 7.23
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. Classic Charcot triad of abdominal pain, fever, and jaundice seen only in about 40% of patient.
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:
• Hb = 76 (between 7 and 9.9) = moderate anaemia.
Normal MCH and MCV so we have normochromic anaemia.
• WBC = 1.5 (N = 0.9) = mild leukopenia with moderate neutropenia.
• Platelets = 31 (between 70 and 20) = moderate thrombocytopenia.