Acid-Base & Lytes

Dangerous electrolytes – part 2

April 24, 2012

Reviewing the patient thus far:   The patient, a 40-something year old woman, has a long history of alcohol abuse.  Recently she has had minimal oral intake with much vomiting.  BP 100/60, pulse 120 120 67 32 99 1.9 21 0.7  8.9   pH 7.6 pCO2 26 pO2 100 HCO3 21   Your job is [...]

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Dangerous electrolytes – part 1

April 22, 2012

3 days ago, at the IM2012 meeting, I presented a 1 hour session on dangerous electrolyte disorders.  The patient presentation I used has many parts, so I thought you would like to work through this one.   The patient, a 40-something year old woman, has a long history of alcohol abuse.  Recently she has had [...]

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Answer to the acid-base question from 2 days ago

February 11, 2012

To restate:   35-year-old man admitted for worsening ascites. We know the patient because he had just left AMA 3 days before.  He had HIV with a low CD4 and did not take any anti-retrovirals.  He also had hep C cirrhosis with encephalopathy and worsening ascites.  He did take spironolactone and lactulose and the lactulose [...]

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An acid-base question

February 9, 2012

35-year-old man admitted for worsening ascites. We know the patient because he had just left AMA 3 days before.  He had HIV with a low CD4 and did not take any anti-retrovirals.  He also had hep C cirrhosis with encephalopathy and worsening ascites.  He did take spironolactone and lactulose and the lactulose was causing diarrhea. [...]

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VA Dec 2011 – day #3 – my thoughts on the acid-base problem

December 18, 2011

  50 something patient with combination of restrictive and obstructive disease.  This electrolyte panel caught everyone's attention. 139 91 25 3.0 42 1.2 ABG pH 7.45 pCO2 59 pO2 59 Bicarb 41 What likely happened to this patient?  What do you want to do now? An elevated bicarbonate suggests two possibilities – metabolic alkalosis or [...]

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VA Dec 2011 – day #2 – an acid-base problem

December 17, 2011

50 something patient with combination of restrictive and obstructive disease.  This electrolyte panel caught everyone's attention. 139 91 25   3.0 42 1.2   ABG pH 7.45 pCO2 59 pO2 59 Bicarb 41 What likely happened to this patient?  What do you want to do now?

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November acid-base – final thoughts

November 25, 2011

  50 something woman admitted for nausea and recurrent vomiting and right flank pain.  She denies hematemesis or melena.  She smokes 1 pack per day and drinks 8-9 beers per day.  She is thin, weighing around 54 kg. Labs are drawn, and the patient is admitted. 125 73 15 49 2.8 8 0.6 Your job [...]

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November acid-base part 2

November 17, 2011

  50 something woman admitted for nausea and recurrent vomiting and right flank pain.  She denies hematemesis or melena.  She smokes 1 pack per day and drinks 8-9 beers per day.  She is thin, weighing around 54 kg. Labs are drawn, and the patient is admitted. 125 73 15 49 2.8 8 0.6   Your [...]

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November acid base electrolyte quiz

November 15, 2011

50 something woman admitted for nausea and recurrent vomiting and right flank pain.  She denies hematemesis or melena.  She smokes 1 pack per day and drinks 8-9 beers per day.  She is thin, weighing around 54 kg. Labs are drawn, and the patient is admitted. 125 73 15 49 2.8 8 0.6   Your job [...]

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Electrolyte disorders – need your opinion

September 15, 2011

I am giving a talk at the ACP meeting this coming year on dangerous electrolyte disorders.  Please vote on which disorders I should emphasize. My current plans include: Hyponatremia Hypophosphatemia Hypercalcemia but I am still considering Hypokalemia Hyperkalemia Hypomagnesemia   I need your help – what disorders would interest you most?

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