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Hypernatraemia

CASE A 76 yo woman is sent in from the nursing home with myoclonic jerks. She has a past medical history of slight dementia and seizures. Her GCS is 13-14/15. On arrival she has constant myoclonic jerks. Initial Blood tests reveal the following: Na 165 K 3.6 Cl 112 U 12 Cr 112 You make…

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Lactation Ketoacidosis

I go on about how important it is to be able to interpret blood gases, with our junior doctors and Fellowship Candidates. It can really change your diagnostic capabilities in the emergency department. Here is an interesting case, where gases solve the problem. A 30 yo woman is transferred to your emergency department. She has…

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Hyponatraemia- Working it out

Hyponatraemia is the most common electrolyte abnormality that we see. It’s important to be able to quickly diagnose the causes of this. Below is a 6 minute video that summarises  an approach to the causes of hyponatraemia. Although not as simplistic as this, but my simple approach is: 1. Correct for increased glucose 2. If…

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Solution to ‘The Patient has GAS’

A few people had a go. Well done! This is a tough one. This is my roundabout way of working it out. Probably not as slick as it should be but….it does the job.  It IS a triple acid base abnormality and the diagnosis is probably salicylate toxicity. Sure the patient has a fever and…

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The patient has ‘GAS’

Its the end of the week and those brain cells are slowing down a little, so here is a little diagnostic quiz for you. The feared blood gas! Now I know some of you say that I don’t do arterial gases any more, just venous, so I don’t need to worry about it………..common have a…

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