A femoral arterial blood gas sample is obtained from a 41 year old man…obtained when the barometric pressure was 272mmHg and the PiO2 47mmHg
A 57 year old man presents to the ED with 18 hours of severe upper abdominal pain, fever, nausea and vomiting. He looks jaundiced, his HR is 120bpm, BP 110/60, RR 22 and his temperature is 37.8oC. He is tender and guarded in his right upper quadrant on abdominal palpation.
Exercise-associated Hyponatremia HYPOnatremia Interpretation Seizures, hyponatremia and ADH Cause of HYPOnatraemia Definition: Serum sodium <130mEq/l Cause: Excess of Water relative to Sodium Affects: 1% of hospital population Hypovolemic (Na deficit in xs of water deficit) (test urine sodium) RENAL (urinary Na >20mmol) Addison’s Renal failure (Diuretic stage) Salt losing nephropathy (RTA) Diuretic- Thiazides and osmotic […]
Water loss in excess of salt deficit. Hypernatremia is usually due to insufficient water (primarily in patients who either do not experience thirst normally, or cannot act on it). Hypernatraemia occurs less commonly associated with excess salt
CAUSES pre-existing liver disease (+/- exacerbation) drug induced (paracetamol, statins, amiodarone, antibiotics, NSAIDs, beta-blockers, ranitidine, volatiles) ischaemic (post clamping above hepatic artery, thrombosis, embolic, hypotension) surgical injury nutrition (TPN, EN) acalculous cholecystitis transfusion related hepatitis ASSESSMENT History pre-operative liver function drug history anaesthetic and surgical notes review transfusion history nutrition Examination liver dysfunction signs (jaundice, […]
Syndrome Of Inappropriate ADH secretion (SIADH) is hyponatraemia due to an increase in concentration of ADH inappropriate to the current osmotic or volume status. The differential diagnosis includes ADH analogues
Hypokalaemia: the most common electrolyte abnormality in hospitalised patients; mostly caused by drugs and GI disease
Hypocalcaemia: Reduced intake; redistribution and increased output