A Most Discombobulating Gas
Are you discombobulated by this blood gas? It will lead you down an unexpected path...
Category Metabolic
Exercise-associated Hyponatremia
A 30 year-old female was BIBA to the ED following a seizure. She was running a marathon in hot weather. Nearing the end, after 5 hours running, she was seen fall to the ground and had a generalised tonic-clonic seizure.
Hypokalaemic Periodic Paralysis
Hypokalaemic Periodic Paralysis; rare channelopathy; muscle weakness/paralysis with a matching fall in K+ levels; starts in adolescence; weakness may be mild -> full body paralysis
Alcoholic Ketoacidosis
Alcoholic Ketoacidosis: rare; small proportion of chronic ethanol abusers; relatively benign if patients given IV dextrose and fluids; unclear aetiology
Oxidative Stress in Critical Illness
Oxidative stress is refers an imbalance between production of reactive oxygen species and the protection of antioxidants, due to the accumulation of free radicals and/or the inability of antioxidants to counter their accumulation or effects.
Chloride in Critical Illness
Chloride is the major anion in the extracellular fluid (ECF) and is the second most important contributor to plasma tonicity. The possibility of harm from hyperchloraemia, particularly in the context of fluid resuscitation with chloride-rich solutions such as normal saline, is an area of intense research interest
Ammonia and hyperammonaemia
OVERVIEW Hyperammonaemia is easily forgotten as a potential cause of metabolic encephalopathy Ammonia is produced by the hepatic metabolism of amino acids and is primarily degraded via the urea cycle In the absence of obvious liver dysfunction or a drug…
Hyponatraemic Seizures
Seizures and hyponatremia in a 10 year-old boy - can you answer the questions and find the solutions to the case-based questions in this laboratory tester?
Young and Yellow
Fulminant hepatic failure is defined as the appearance of hepatic encephalopathy in a patient with acute deterioration of liver function with no previous history of liver disease.
Ammon Anyone?
You've just been handed over a patient who has an altered mental status when the phone rings. It's the lab - you're told that your patient has a serum ammonia level of 250 umol/L (reference range, 11-35 umol/L). WTF?
Pregnant and Acidotic
A pregnant patient has pneumonia. There are also concerns that she has a metabolic acidosis. Can you solve this metabolic muddle?
CATMUDPILES
76 year old male living alone. Found obtunded at home by neighbours. Breathing rapidly and muttering incoherently. No other history available. CATMUDPILES?