Case 18 – update 3

ITU registrar arrives to review your patient.  He agrees to HDU support and the patient is planned for transfer.  A few further investigations become available.

LDH – 4150

ABG pH 7.24, pCO2 2.6, pO2 11.5, HCO3- 14, be -8

Retics – 1.5%

MCV 84

ECG – tented t-waves!

What are the potential causes for the hyperkaleamia/renal failure in this genetleman?

What does the ABG show?

any further investigations which may help you with identifying the cause – other than abdominal imaging?  Radiology have agreed to abdo USS once patient had been stabilised.

Any further treatment you can give immediately?

You also speak to the haematology lab, who will review a blood film, and surgeons will review patient as soon as available.

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