A 3 month old girl is brought to your Emergency department after 3 days of diarrhoea and vomiting. She is unwell, lethargic, has sunken eyes, a sunken fontanelle and dry mucous membranes.

Describe and interpret her biochemical results

Veonus blood gas

FiO2                    50 %

pH                       7.12  (7.36-7.44)

pCO2                   12  (35-45mmHg)

pO2                      103 mmHg

O2 saturation         98%

base excess           -25    (-3-+3)

bicarbonate            4 (24-32mmol/l)

Lactate                  3.6 ( 0.5-2.0 mmol/l)

Electyrolytes

sodium          155 (135-145 mmol/l)

potassium      3.0 (3.5-4.8mmol/l)

Chloride         136 (95-110 mmol/l)

Urea               15.4 (3-8 mmol/l)

Creat               45 (50-120 mmol/l)

Glucose           6.1 (3-6 mmol/l)

This one is from the fellowship exam of a few years ago.