Lab Case 205

66 year old female presents complaining of anuria for the past 48 hours. She reports nausea and vomiting over the last week. She has a background history of IHD, having undergone a CABG 6 weeks ago. She also has Type 2 DM on Metformin and Gliclazide.  The patient baseline Cr is 150umol/l

ABG on FiO2 0.4

pH 6.941                                            Na 139 mmol/l

pCO2 9.5 mmHg                              K 5.7mmol/l

pO2 168mmHg                                 Cl 105mmol/l

HCO3 1.9mmol/l                             Glu 5.5 mmol/l

B/E -29.3                                           Cr 659 umol/l

Lactate 18 mmol/l                          Hb 94g/l


  1. Describe and Interpret the ABG
  2. Name the types of lactic acidosis and give examples of each.

Lab Case 202

A 68 year old female is brought to ED by ambulance. her husband found her this morning confused and called the ambulance. He had last seen her last night before bed when she was well.


She takes propranolol, metformin, gliclazide, SGLT 2 inhibitor for diabetes

In ED the patient was obtunded Continue reading

Lab Case 184

55 Year old female presents with a 1 week history of diarrhoea and vomiting. She has recently been discharged from hospital after treatment of spontaneous bacterial peritonitis. She has a background of cirrhosis of the liver and diabetes on metformin+dapagliflozin combination. The patient has a needle phobia and was hyperventilating for some time prior to the insertion of the drip.

Continue reading

Lab Case 159

A 60 year old male presents with 1 week history of vomiting. In the last 24 hours the family noted that he was confused and poor to respond. Background – IHD, HTN, NIDDM on Metformin, Coversyl, aspirin, metoprolol.

On arrival he was confused.

Vitals: BP  80/40   HR 46/min   Temp  34   RR 24/min and GCS 10 Continue reading