SAQ Stack

Short Answer Questions for ED Fellowship Study

Case: Dizzy and myalgias with CCF

A 65-year-old man is bought into ED by his wife with myalgia and dizziness. He has a past history of IHD, COPD. He had a short stay in hospital a few weeks ago with first presentation of CCF and started several new medications. Since being discharged home, he has progressively developed myalgia and for the last 2 days has been generally dizzy with several episodes of presyncope. He denies fever, cough, chest pain, abdominal pain, vomiting, diarrhoea, or any other symptoms. His observations are as follows: HR 55 CRT 4s RR 10 Sats 90% RA T 36.5 VBG results : pH 7.50 pCO2 60 pO2 62 K+ 1.7 Na+ 142 Cl- 98 Glu 5.8 Lac 1.8 Crea 88 HCO3 46

1. Interpret the venous blood gas showing all formulas used. 4 marks

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2. List two explanations for the abnormalities found in his venous blood gas. 2 marks

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3. List two complications of this metabolic disturbance. 2 marks

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4. Outline four points in your management plan for this patient. 4 marks

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This case forms part of a collaborative marking project designed to support fellowship preparation. In the week leading up to each tutorial, you can contribute answers to any active case. If you contribute, your answers may be reviewed, marked, and used to refine the model answers during the weekly fellowship teaching sessions.

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After the tutorial you can still do the case and self-mark your answers, but your answers will not be included in the group review.