Case 1: A 60-year-old man with insulin - treated type 2 diabetes experienced severe central chest pain, associated with nausea. He refused to let his wife call the doctor, but went to bed and, since he felt too ill to eat, he stopped taking his insulin. Two days later, he had another episode of chest pain and became breathless. His wife called an ambulance, and he was admitted. He was shocked, with central cyanosis, pulse 120/min, blood pressure 66/34, respiratory rate 30/min. An ECG demonstrated a large anterior myocardial infarct. The results of acid-base analyses were as follows: Blood gas analyses Results H--39 nmol/L CO₂-2 kPa HCO, 9.4 mmol/L 0₂-7 kPa What is his acid-base status, and what may have caused it? Case 2: A 14-year-old boy was found by his mother in a drowsy and unco - operative state. When the GP arrived, she told her that her son had seemed to be unusually thirsty for the last 1-2 months, and she thought that he had lost weight. Recently, he had been complaining of abdominal pain and discomfort. He was admitted to a hospital as an emergency. On examination he was semi- conscious, with deep sighing respiration, a pulse rate of 120/min, a blood Serum Result Urea 24.5 mmol/L Na+128 mmol/L pressure of 94/56 and cold extremities. Chemical investigations on blood after admission showed the following: K+6.9 mmol/L Fasting Plasma Glucose - 3 mmol/L Blood gas analysis Result H--82 nmol/L CO₂-2.9 kPa Reference range 36-44 nmol/L 4.46.1 kPa HCO, -7.0 mmol/L 0₂ 14.0 kPa 21.0 27.5 mmol/L 12-15 kPa Comment on these results. Reference range 2.5-6.6 mmol/L 135-145 mmol/L 3.6-5.0 mmol/L 3.9-5.6 mmol/L Reference range. 37-45 nmol/L 4.5-6.0 kPa 21-29 mmol/L 12-15 kPa What is the probable diagnosis (due to low glucose, age-14 years, high potassium, and.......)? What does the ABG (Arterial blood gas) analysis show? Case 3: A well-trained marathon runner collapsed as he was approaching the finishing line. An ECG was normal, but CK was elevated at 9500 U/L (reference range 30-200 U/L), and the CK - MB was 14% of the total CK (normally < 6%). Troponin was undetectable.

Case 1: A 60-year-old man with insulin - treated type 2 diabetes experienced severe central chest pain, associated with nausea. He refused to let his wife call the doctor, but went to bed and, since he felt too ill to eat, he stopped taking his insulin. Two days later, he had another episode of chest pain and became breathless. His wife called an ambulance, and he was admitted. He was shocked, with central cyanosis, pulse 120/min, blood pressure 66/34, respiratory rate 30/min. An ECG demonstrated a large anterior myocardial infarct. The results of acid-base analyses were as follows: Blood gas analyses Results H--39 nmol/L CO₂-2 kPa HCO, 9.4 mmol/L 0₂-7 kPa What is his acid-base status, and what may have caused it? Case 2: A 14-year-old boy was found by his mother in a drowsy and unco - operative state. When the GP arrived, she told her that her son had seemed to be unusually thirsty for the last 1-2 months, and she thought that he had lost weight. Recently, he had been complaining of abdominal pain and discomfort. He was admitted to a hospital as an emergency. On examination he was semi- conscious, with deep sighing respiration, a pulse rate of 120/min, a blood Serum Result Urea 24.5 mmol/L Na+128 mmol/L pressure of 94/56 and cold extremities. Chemical investigations on blood after admission showed the following: K+6.9 mmol/L Fasting Plasma Glucose - 3 mmol/L Blood gas analysis Result H--82 nmol/L CO₂-2.9 kPa Reference range 36-44 nmol/L 4.46.1 kPa HCO, -7.0 mmol/L 0₂ 14.0 kPa 21.0 27.5 mmol/L 12-15 kPa Comment on these results. Reference range 2.5-6.6 mmol/L 135-145 mmol/L 3.6-5.0 mmol/L 3.9-5.6 mmol/L Reference range. 37-45 nmol/L 4.5-6.0 kPa 21-29 mmol/L 12-15 kPa What is the probable diagnosis (due to low glucose, age-14 years, high potassium, and.......)? What does the ABG (Arterial blood gas) analysis show? Case 3: A well-trained marathon runner collapsed as he was approaching the finishing line. An ECG was normal, but CK was elevated at 9500 U/L (reference range 30-200 U/L), and the CK - MB was 14% of the total CK (normally < 6%). Troponin was undetectable.