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Case 1
Case 2
HANG ON A MINUTE!
No!
The pattern (PCO2 elevated, HCO3 borderline
elevated) suggests either a respiratory
acidosis or a metabolic alkalosis but the
severe acidaemia means that it is a
respiratory acidosis that is present. This much
is common ground to these two cases. The
clinical details are necessary to decide if a
simple or a mixed acid-base disorder is
present.
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And Patient 2?
Compensatory Responses
Scenario
Blood tests
IV fluids
Most cases of infective enterocolitis are viral, but the
possibility of a bacterial infection may merit antibiotic therapy
What bacterial infections may be responsible?
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E. Coli
Campylobacter
Salmonella
Clostridium difficile?
Cardiff MRCS OSCE Course www.doctorsacademy.org
The patient receives 3 litres of 0.9% saline over the next three
hours. Despite this, his urine output remains poor although his
pulse and BP both improve. You decide to re-check his U&E
and an arterial blood gas
Cardiff MRCS OSCE Course www.doctorsacademy.org
Abnormal saline!
Electrolyte solutions
Hartmanns 0.9% Saline Dextrose/
Solution Saline
Sodium (mmol/l) 131 150 30
Thank you!