For each set of the following biochemical and arterial blood gas parameters:
- a) Describe the abnormalities.
- b) Give one example of an associated clinical scenario.
Any reasonable scenario accepted that was both biochemically correct AND clinically likely.
Answer and interpretation
- Increased anion gap and normal anion gap metabolic acidosis with appropriate respiratory
- Clinical scenario – diabetic ketoacidosis with ketonuria or DKA with N saline resuscitation.
- Increased anion gap, metabolic alkalosis and respiratory alkalosis.
- Clinical scenario – salicylate overdose.
- Increased anion gap metabolic acidosis and metabolic alkalosis.
- Clinical scenario – acute renal failure with vomiting .
- Acute respiratory acidosis with metabolic alkalosis.
- Clinical scenario – acute respiratory failure in COAD (Acute on chronic respiratory failure.
- Acute respiratory alkalosis.
- Clinical scenario – Psychogenic hyperventilation.
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.