Question

A 15 year old girl in a coma was brought to the emergency room by her parents. She has been an insulin dependent diabetic for 7 years. Her parents stated that there have been several episodes of hypoglycemia and ketoacidosis in the past, and that their daughter has often been “too busy” to take her insulin injections. The laboratory results obtained on admission are shown in Case study Table 14-5.1

1. Calculate the osmolal gap.

2. What method was used to measure Na+?

3. Are these results valid? Explain why?

Venous Blood                   Result                                   Reference Range

Sodium                                 145 mmol/L                        136-145 mmol/L

Potassium                           5.8 mmol/L                         3.4-5.0 mmol/L

Chloride                               87 mmol/L                           98-107 mmol/L

Bicarbonate                        8 mmol/L                             22-29 mmol/L

Glucose                                1,050 mg/dL                       70-110 mg/dL

Urea nitrogen                    35 mg/dL                             7-18 mg/dL

Creatinine                           1.3 mg/dL                            0.5-1.3 mg/dL

Lactate                                 5 mmol/L                             0.5-2.2 mmol/L

Osmolality                           385 mOsmol/kg                275-295 mOsmol/kg

Answer 1