A 52-year-old man with a history of alcohol abuse and Type 2 diabetes is admitted with the abdominal pain. His arterial blood gases and biochemical profile are as follows:
Parameter |
Result |
Normal Range |
Barometric pressure |
760 mmHg (100 kPa) |
|
FiO2 |
0.5 |
|
pH |
7.14* |
7.35 – 7.45 |
PCO2 |
12 mmHg (1.1 kPa)* |
35 – 45 (4.7 – 6.0) |
PO2 |
149 mmHg (20 kPa) |
|
Bicarbonate |
4 mmol/L* |
22 – 26 |
Lactate |
16 mmol/L* |
<2.0 |
Sodium |
142 mmol/L |
135 – 145 |
Potassium |
4.7 mmol/L* |
3.2 – 4.5 |
Urea |
14 mmol/L* |
3.0 – 8.0 |
Creatinine |
0.17 mmol/L* |
0.07 – 0.12 |
Glucose |
6.5 mmol/L |
3.6 – 7.7 |
Total Bilirubin |
20 micromol/L |
4 – 25 |
LDH |
1400 U/L* |
50 – 150 |
AST |
60 U/L* |
<40 |
ALT |
70 U/L* |
<40 |
Serum Osmolality |
314 mOsm/Kg* |
275 – 295 |
a)
b)
This question is identical to Question 15.3 from the second paper of 2009, and Question 26.4 from the second paper of 2013. The answer to the latter contains a comprehensive discussion.