Clinical Case 6

A 36-year-old man is brought to the ED. He is confused and agitated and unwilling to give any history. His BP is 130/60 mmHg and he is tachycardic and tachypnoeic. Examination is otherwise unremarkable. An ABG demonstrated acidosis (pH 7.1) and an elevated lactate (6 mmol/L). Blood results include: glucose 6 mmol/L, sodium 140 mmol/L, K 6.6 mmol/L, Cl 110 mmol/L, HCO3 3 mmol/L and Cr 198 umol/L. The serum osmolality is 320 mmol/kg (275-295) and the osmolar gap (the difference between the measured value and the predicted value) is 20 mmol/kg (normally <10).

His anion gap is normal. True or false?

Emergency dialysis is an essential component of the treatment for his condition. True or false?

Dialysis can be used to treat overdoses of most drugs. True or false?