A 27 year old female presents to your ED with a 2 day history of sore throat, cough and fevers. She has a history of “endocrine problems/ auto immune disease” and is on insulin and thyroxine. She also has Coeliac disease.
Vitals:
T 37.7
PR 130/min
BP 105/50
Her blood results:pH 7.357
pCO2 38.6mmHg
HCO3 21 mmol/l
BE -3.5
Na 128 mmol/l
K 5.5 mmol/l
Cl 93 mmol/l
Glu 19.3 mmol/l
Lactate 2.3 mmol/l
Urea 7.4 mmol/l
Creat 134 umol/l
Describe and interpret the blood results
Give a reasonable differential diagnosis
How would you treat her?