ABB/Questions and Case Studies
Questions[edit | edit source]
Case Studies[edit | edit source]
Patient with scoliosis and cardiac defect[edit | edit source]
A 17-year-old patient admitted to the hospital with congestive heart defect and scoliosis. Laboratory investigated on admission and again 24 h later.
- Proteins 1 g
- pH = 6
- 3-6 hyaline cylinders
- other findings normal
|on admission||after 24 h|
|pCO2||14,0 kPa||5,3 kPa|
|HCO3−||40 mmol/l||29 mmol/l|
|BE||5,0 mmol/l||5,0 mmol/l|
|pO2||17,6 kPa||17,6 kPa|
|saturace O2||97,90 %||99 %|
|Na+||146 mmol/l||139 mmol/l|
|K+||5,0 mmol/l||3,3 mmol/l|
|Cl−||94 mmol/l||96 mmol/l|
|glycemia||6,9 mmol/l||4,8 mmol/l|
|urea||6,0 mmol/l||1,7 mmol/l|
|creatinine||45 μmol/l||75 μmol/l|
|CK||3,6 μkat/l||2,4 μkat/l|
|LD||4,1 μkat/l||3,8 μkat/l|
|Hb||189 g/l||165 g/l|
|hematocrit||58,80 %||50,70 %|
- What was the ABB disorder on admission?
- What was the ABB impairment after 24 h?
- What was the cause of the decrease in serum K+ over 24 h?
- Does the clinical status correspond to the laboratory findings?
Patient in acute respiratory distress[edit | edit source]
A 51-year-old man admitted to hospital with acute respiratory distress syndrome (ARDS). The patient smokes 3 packs of cigarettes a day.
|saturation O2||76 %|
|venous saturation||54 %|
|2,3-bisphosphoglycerate||5,3 j. (norma 3,3-5,3)|
- How do you rate ABB at the time of patient admission?
- Is the oxyhemoglobin dissociation curve shifted?
- What is the significance of the other results?
Patient in diabetic coma[edit | edit source]
A 15-year-old girl is brought to the E.R. in a coma. She's been diabetic for 7 years, taking insulin. She's had several bouts of hypoglycemia and ketoacidosis. She has had a lot of studying at school recently and may have neglected some insulin injections.
|saturation O2||97,90 %|
|calculated osmolarity||346 mmol/l|
|anion gap||58,3 mmol/l|
- What is the diagnosis?
- Calculate the anion gap (AG), what is the cause of the high AG?
- What is the significance of the increased osmolality?
- Why are chloride and HCO3- decreased, what is the significance of "normal" Na+ and increased K+?
Patient with pulmonary insufficiency and hypokalemia[edit | edit source]
Patient 55 years old, with chronic obstructive pulmonary disease, who was treated for a long time with thiazide preparations (as a diuretic).
Laboratory results on admission
- What is the fault in ABB?