DB'S MEDICAL RANTS

Internal medicine, American health care, and especially medical education

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An acid base puzzle from rounds

Started rounds today and had several interesting laboratory findings.  I plan to post some patient quizzes for the next 3 days.

Electrolyte panel
Na 141 Cl 112 BUN 18
K 4.3 HCO3 15 creat 0.7
Blood Sugar 105
ABG
pH 7.33
pCO2 25
pO2 103
calc HCO3 13

 

Today’s patient is well known to our service.  She is 32 and has a long history of Crohn’s disease, with an ileostomy.  Consider the differential diagnosis, and recommend tests to prove your hypothesis.

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