Gas Goblin: Case #18

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The Pills Behind the Palpitations

A 23-year-old woman presents with dizziness and palpitations. Her meds include OTC laxatives and ‘diet pills’ purchased online.

VBG
pH: 7.5 (7.35 – 7.45)
pO₂: 39 mmHg (75 – 100)
pCO₂: 46 mmHg (35 – 45)
HCO₃⁻: 34 mmol/L (22 – 26)
BE: 10 mmol/L (-3 – 3)
SaO₂: 100 % (94 – 100)
Na⁺: 138 mmol/L (135 – 145)
K⁺: 2.7 mmol/L (3.5 – 5.5)
Cl: 85 mmol/L (95 – 110)
Ca: 1.18 mmol/L (1.12 – 1.3)
Lactate: 1 mmol/L
Glucose: 4.7 mmol/L (4 – 8)
Urea: 9 mmol/L
Creatinine: 72 μmol/L
Osmolarity: 285 mOsm/L
COHb: 1 % (0.2 – 2)
MetHb: 1 %
fiO2: 0.21

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Parameters

Sample Type VBG

pH

pO₂ (mmHg)

pCO₂ (mmHg)

HCO₃⁻ (mmol/L)

BE (mmol/L)

SaO₂ (%)

Na⁺ (mmol/L)

K⁺ (mmol/L)

Cl (mmol/L)

Ca (mmol/L)

Lactate (mmol/L)

Glucose (mmol/L)

Urea (mmol/L)

Creatinine (μmol/L)

Osmolarity (mOsm/L)

COHb (%)

MetHb (%)

fiO2

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