MedBugs: SAQ #231

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Case: Alcoholic ketoacidosis with mixed acid-base disorder

A 63-year-old woman with alcohol use disorder presents with abdominal pain, nausea and vomiting after heavy alcohol intake. A venous blood gas is performed. pH 7.14 pCO2 24 HCO3 11 Na 145 K 5.5 Cl 98 Lactate 2.6 Glucose 3.2 Hb 140

1. Identify the metabolic acid-base abnormalities and provide calculations. 6 marks

2. List three additional blood tests with rationale. 3 marks

On examination, the patient is confused. She has a soft abdomen with mild generalised tenderness but no peritonism. There are no features of sepsis. Her vitals are as follows : GCS 14 T 36.5 HR 120 BP 85/55 RR 30

3. State three steps in initial management. 3 marks

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Case: Alcoholic ketoacidosis with mixed acid-base disorder

1. Identify the metabolic acid-base abnormalities and provide calculations. 6 marks

2. List three additional blood tests with rationale. 3 marks

3. State three steps in initial management. 3 marks

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