This is the first of 3 weeks of posts. We’d love readers to play along and post up some answer suggestions on our facebook page (https://www.facebook.com/fellowshipexam).
A patient presents semiconscious after an unknown overdose. His medical history indicates a history of epilepsy, but there is no medical record of his medications listed. Initial bloods in resus are taken: Venous gas: pH 7.12 pCO2 26 mmHg HCO3- 12 mmol/L Na+ 140 mmol/L Cl- 104 mmol/L Creatinine 60 umol/L Urea 4 mmol/L BSL 5.5 mmol/L Ketones Not detected. Lactate 10 mmol/L We’ve thrown this out in this week’s 5 point fellowship Friday to emphasise a couple of really important points about understanding the exam. Work through the ABG and calculate the acid base disturbances. Then ask yourself: 1.What are the possible diagnoses? 2.Are there any further bloods you need to check? 3.Are there any other bedside tests you’d run? 4.Is there a rare antidote you might have to give this patient? *Every piece of information you have been given is fair game for your analysis.* Share your thoughts on our facebook page at https://www.facebook.com/fellowshipexam. If you want to read an ABG/VBG in 5 steps go to the RESUS Page
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AuthorShareThe Written Fellowship Course has its beginnings back in 2007, When Dr Kas started it at RPA in Sydney. It was then called the Kamikaze Course. Archives
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