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Original post by HumblyBumbly
^^^ just for you @ecolier :wink:

Since you are all off ... thought if any of you are keen to read some medicine before you start your degrees I could put a random clinical case on here each day and we could discuss. Helps me learn stuff too (I am a medic FYI). Any keen beans?

Sounds like a winner to me... Don't want our prospective medics getting too bored. Let's get those "little grey cells" working!

Are you going to post clinical cases on here, Humbly Bumbly, as ecolier may be a tad busy
Original post by HumblyBumbly
^^^ just for you @ecolier :wink:

Since you are all off ... thought if any of you are keen to read some medicine before you start your degrees I could put a random clinical case on here each day and we could discuss. Helps me learn stuff too (I am a medic FYI). Any keen beans?

I am not a bean but I am very keen! I would love to join the discussion and learn new stuff. Thank you for offering us this great opportunity. :smile:
Original post by HumblyBumbly
^^^ just for you @ecolier :wink:

Since you are all off ... thought if any of you are keen to read some medicine before you start your degrees I could put a random clinical case on here each day and we could discuss. Helps me learn stuff too (I am a medic FYI). Any keen beans?

I am a keen bean indeed!
Original post by sendnukes
I am a keen bean indeed!

Looks like you are starting to collect a small audience, Humbly Bumbly.
Original post by Oxford Mum
Looks like you are starting to collect a small audience, Humbly Bumbly.


Original post by sendnukes
I am a keen bean indeed!


Original post by Mirabilandia_
I am not a bean but I am very keen! I would love to join the discussion and learn new stuff. Thank you for offering us this great opportunity. :smile:

Okay how about we start with something called an ABG. A 57-year-old gentleman presents to the emergency department complaining of nausea, vomiting and abdominal pain. You take a urine sample and also a blood sample. The test results show elevated ketone levels.

Measurement of his blood glucose level is 3mmol/L. An ABG is performed and shows the following results: pH 7.24 PaO2 14.7 kPa PaCO2 3.5 kPa HCO3 13 mmol/L What do you think is the underlying cause of his pathology?

Why don't you guys read up a little on ABGs, and have a think about what might be going on and then we can discuss this case in more detail. I can give you clues as we go along.

Anybody that does know this very easily no spoilers - it's always more fun to work things out on your own a bit!

NB: I know this is quite high level. But it's cool to start somewhere. Here are some normal values:

pH 7.35 - 7.45
pCO2 4.5 - 6.0 kPa
pO2 10 - 14 kPa
HCO3 22-28 mmol/l
(edited 4 years ago)
Original post by HumblyBumbly
Okay how about we start with something called an ABG. A 57-year-old gentleman presents to the emergency department complaining of nausea, vomiting and abdominal pain. You take a urine sample and also a blood sample. The test results show elevated ketone levels.

Measurement of his blood glucose level is 3mmol/L. An ABG is performed and shows the following results: pH 7.24 PaO2 14.7 kPa PaCO2 3.5 kPa HCO3 13 mmol/L What do you think is the underlying cause of his pathology?

Why don't you guys read up a little on ABGs, and have a think about what might be going on and then we can discuss this case in more detail. I can give you clues as we go along.

Anybody that does know this very easily no spoilers - it's always more fun to work things out on your own a bit!

NB: I know this is quite high level. But it's cool to start somewhere. Here are some normal values:

pH 7.35 - 7.45
pCO2 4.5 - 6.0 kPa
pO2 10 - 14 kPa
HCO3 22-28 mmol/l


Really? :tongue:
Original post by Democracy
Really? :tongue:

Just some basic ideas about numbers that are off e.g. pH being too high or too low is a good start and we can build from there. Don't stress Democracy, not expecting a diagnosis.
Original post by HumblyBumbly
Just some basic ideas about numbers that are off e.g. pH being too high or too low is a good start and we can build from there. Don't stress Democracy, not expecting a diagnosis.

I'm not stressed my guy. Just wondering whether you're sure about that blood glucose measurement.

Otherwise I think this thread is a great idea.
Yeah, I thought I knew the diagnosis until I saw the blood glucose. To be fair, perhaps my initial thought was wrong.
I completely missed the blood glucose too D:
Original post by Democracy
I'm not stressed my guy. Just wondering whether you're sure about that blood glucose measurement.

Otherwise I think this thread is a great idea.


Original post by Chief Wiggum
Yeah, I thought I knew the diagnosis until I saw the blood glucose. To be fair, perhaps my initial thought was wrong.

yes I know what you both thought it was but ... it isn't that. The blood glucose was meant to be that low !!!

Let's see what the A-level students get back to us with and then we can discuss
(edited 4 years ago)
Reply 12
I've looked up what an ABG is and it says that it's a blood test to measure the acidity/pH/oxygen and carbon dioxide levels in the blood from an artery.
It's a way to see how well the lungs are working. Looking at the normal pH levels, this person's blood pH is too low but closer to neutral pH.. I think more co2 in the blood causes pH to be more acidic.
However, what's slightly confusing is that the O2 levels are too high (high partial pressure of oxygen) and co2 levels are too low (low partial pressure of carbon dioxide). So there's too much oxygen in the blood and not enough carbon dioxide.
I also think that the low HCo3 levels also contribute to the abnormal blood pH level as I believe HCo3- ions act as a ph buffer to prevent changes in pH. If there's not enough of these ions then pH can fluctuate, I think.
I'm really not sure about any of these suggestions as I've just looked at the data and tried to apply any knowledge I have from A level bio.
Original post by HumblyBumbly
Okay how about we start with something called an ABG. A 57-year-old gentleman presents to the emergency department complaining of nausea, vomiting and abdominal pain. You take a urine sample and also a blood sample. The test results show elevated ketone levels.

Measurement of his blood glucose level is 3mmol/L. An ABG is performed and shows the following results: pH 7.24 PaO2 14.7 kPa PaCO2 3.5 kPa HCO3 13 mmol/L What do you think is the underlying cause of his pathology?

Why don't you guys read up a little on ABGs, and have a think about what might be going on and then we can discuss this case in more detail. I can give you clues as we go along.

Anybody that does know this very easily no spoilers - it's always more fun to work things out on your own a bit!

NB: I know this is quite high level. But it's cool to start somewhere. Here are some normal values:

pH 7.35 - 7.45
pCO2 4.5 - 6.0 kPa
pO2 10 - 14 kPa
HCO3 22-28 mmol/l

hey a year 12 here - fantastic idea for a thread! We've just covered haemoglobin dissociation curve at school (over an online lesson!) and was fortunate enough to see an ABG carried out on work experience. Looking at figures, CO2 concentration in blood is lower than expected + partial pressure of oxygen a bit higher. Dissociation into H+ and HCO3- is not happening at the rate it needs to - so CO2 is not associating with haemoglobin? Maybe something intrinsically wrong with hb?
Original post by forbearne
hey a year 12 here - fantastic idea for a thread! We've just covered haemoglobin dissociation curve at school (over an online lesson!) and was fortunate enough to see an ABG carried out on work experience. Looking at figures, CO2 concentration in blood is lower than expected + partial pressure of oxygen a bit higher. Dissociation into H+ and HCO3- is not happening at the rate it needs to - so CO2 is not associating with haemoglobin? Maybe something intrinsically wrong with hb?

It sounds like a great suggestion and tbh as a yr13 I'm not too sure on what it is exactly either. I don't think it can be something intrinsically wrong with the Hb just because the patient is quite old so if something like that was wrong surely he would've displayed symptoms earlier?

Isn't ketones in urine a sign of diabetes??? Though with the blood glucose level that low je suis stumped!

Maybe it's just that the patient is just suffering from some sort of hypoglycemia?

Sksksk I'd really want to find the answer myself but I'm pretty sure I won't be able to without a whole load of help!
(edited 4 years ago)
Original post by HumblyBumbly
Okay how about we start with something called an ABG. A 57-year-old gentleman presents to the emergency department complaining of nausea, vomiting and abdominal pain. You take a urine sample and also a blood sample. The test results show elevated ketone levels.

Measurement of his blood glucose level is 3mmol/L. An ABG is performed and shows the following results: pH 7.24 PaO2 14.7 kPa PaCO2 3.5 kPa HCO3 13 mmol/L What do you think is the underlying cause of his pathology?

Why don't you guys read up a little on ABGs, and have a think about what might be going on and then we can discuss this case in more detail. I can give you clues as we go along.

Anybody that does know this very easily no spoilers - it's always more fun to work things out on your own a bit!

NB: I know this is quite high level. But it's cool to start somewhere. Here are some normal values:

pH 7.35 - 7.45
pCO2 4.5 - 6.0 kPa
pO2 10 - 14 kPa
HCO3 22-28 mmol/l

Hi there, I am a reapplicant from Ireland. Thank you so much for having this thread. I was considering whether one of the values, the bicarbonate levels, in particular, could explain the other values. A reduction in bicarbonate explains why the ph is lower than normal and could explain the low concentration of carbon dioxide, as bicarbonate is exhaled from the lungs as CO2.
This is also accompanied by elevated ketones, therefore, I suspect a case of diabetic ketoacidosis (I just read about it) which is a complication of diabetes.
Hb was a shot in the dark - first thought was diabetes as well but blood glucose level. Have found something called DKA, which presents with quite similar symptoms, but it's the blood glucose that's the problem.
Original post by HumblyBumbly
Okay how about we start with something called an ABG. A 57-year-old gentleman presents to the emergency department complaining of nausea, vomiting and abdominal pain. You take a urine sample and also a blood sample. The test results show elevated ketone levels.

Measurement of his blood glucose level is 3mmol/L. An ABG is performed and shows the following results: pH 7.24 PaO2 14.7 kPa PaCO2 3.5 kPa HCO3 13 mmol/L What do you think is the underlying cause of his pathology?

Why don't you guys read up a little on ABGs, and have a think about what might be going on and then we can discuss this case in more detail. I can give you clues as we go along.

Anybody that does know this very easily no spoilers - it's always more fun to work things out on your own a bit!

NB: I know this is quite high level. But it's cool to start somewhere. Here are some normal values:

pH 7.35 - 7.45
pCO2 4.5 - 6.0 kPa
pO2 10 - 14 kPa
HCO3 22-28 mmol/l

Btw - what are normal blood glucose levels?
Original post by forbearne
Btw - what are normal blood glucose levels?

it says 4-5.4 mmol/L
Original post by forbearne
Hb was a shot in the dark - first thought was diabetes as well but blood glucose level. Have found something called DKA, which presents with quite similar symptoms, but it's the blood glucose that's the problem.

Hello there! Apparently DKA is possible with low blood glucose levels

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