MedBugs: SAQ #80

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Case: Lethargy and dizziness

An 87-year-old male from home, presents with 3 days of lethargy and intermittent dizziness. He has a history of type 2 diabetes, ischemic heart disease and hypertension. His medications include metformin, atenolol and irbesartan. He still drives and works as a part-time handyman. Current observations are as follows :

GCS 15
BP 110/75
RR 18
Sats 94% RA

T 35.5

1. Give your overall interpretation of the ECG 1 mark

He has a VBG taken on room air: pH 7.214 Na 140 pCO2 54.4 K 7.1 HCO3- 20 Cl 100 Hb 129 Ca 1.19 Creat 212 Gluc 9.3 Lact 5.8

2. State (3) abnormalities on this ABG and provide (2) explanations for each 6 marks

3. List (4) investigations you would perform, including a clinical indication for each 4 marks

4. State (6) points of your immediate management plan while awaiting the results of your investigations 6 marks

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Case: Lethargy and dizziness

1. Give your overall interpretation of the ECG 1 mark

2. State (3) abnormalities on this ABG and provide (2) explanations for each 6 marks

3. List (4) investigations you would perform, including a clinical indication for each 4 marks

4. State (6) points of your immediate management plan while awaiting the results of your investigations 6 marks

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