Lab. ~ Extended Matching

Question 1.

Options List

A.) A non-anion gap metabolic acidosis with respiratory compensation

B.) An anion gap metabolic acidosis with respiratory compensation

C.) High anion gap metabolic acidosis with lactic acidosis

D.) High anion gap metabolic acidosis with lactic acidosis and a degree of respiratory acidosis

E.) High anion gap metabolic acidosis with respiratory compensation

F.) High anion gap metabolic acidosis with respiratory compensation and respiratory alkalosis

G.) Mixed metabolic acidosis with predominately anion gap metabolic acidosis

H.) Mixed metabolic acidosis with predominately non-anion gap metabolic acidosis

 

Lead-in Statement:

For each clinical case select the acid-base abnormality

 

Stems:

1. A 3 month old girl is brought to your emergency department after three days of diarrhoea and vomiting. She appears very unwell and lethargic, with sunken eyes, a sunken fontanelle and dry mucous membranes

Her serum biochemical results are as follows:

Lab Med Graph 1

Show Answer

Answer: H

2. A 30 year old man presents to your ED with a 24 hour history of increasing weakness.

An arterial blood gas and electrolytes are performed:

lab med graph 2

Show Answer

Answer: A

 

3. A 2 year old boy is brought to your emergency department by his grandparents, having found him unresponsive at their home. He has no significant past medical history. On examination he is very drowsy with a GCS of 7 (E2, V1, M4) and has the following observations:

Lab Med Graph 3

Venous Blood Gas Results

Lab Med Graph 4

Show Answer

Answer: D

 

4. A 47 year old man with a history of chronic liver disease and schizophrenia is brought to your emergency department by ambulance with acute confusion.

Lab Med Graph 5

Arterial blood gas

Lab Med Graph 6

Show Answer

Answer: F

Author: J Haire

 


Question 2.

Options List

A.) Anion-gap metabolic acidosis; hyperkalaemia; hypokalaemia

B.) Metabolic alkalosis; hyperkalaemia

C.) Metabolic alkalosis; hyperkalaemia; hyponatraemia

D.) Metabolic alkalosis; hypokalaemia; hypernatraemia

E.) Metabolic alkalosis; K normal or low in severe cases

F.) Non-anion gap metabolic acidosis; hyperkalaemia; hyponatraemia

G.) Non-anion gap metabolic acidosis; hypokalaemia; hypernatraemia

H.) Non-anion gap metabolic acidosis; hypokalaemia; hyponatraemia

I.) Non-anion gap metabolic acidosis; K low or normal

 

Lead-in Statement:

For each condition select the most likely combination of metabolic abnormalities.

 

Stems:

  1. Addison’s Disease

Show Answer

Answer: F
  1. Renal tubular acidosis Type I

Show Answer

Answer: I
  1. Conn’s syndrome

Show Answer

Answer: D
  1. Acetazolamide abuse

Show Answer

Answer: H
  1. Cushing’s syndrome

Show Answer

Answer: E

Author: J Haire

Ref: Tintinalli p. 1455, Dunn 4th Ed 476-491; Tox Handbook p.111-112


 

 

 

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