Author: Mathew Alex / Editor: Thomas MacMahon / Reviewer: Jia Luen Goh / Code: PhC2, PhC4, PhP1, SLO1, SLO3 / Published: 03/01/2024
A 30-year-old man is rushed to your resuscitation area, having been found collapsed on the street one warm evening. He is confused and disorientated, with blue lips. His cardiovascular and respiratory examination is unremarkable, and his peripheries are warm.
His observations show a heart rate of 110/min, respiratory rate of 15/min with normal effort, oxygen saturations of 84% on room air, blood pressure of 122/74 mmHg. His oxygen saturations increase to 86% on 15L/O2 via a non-rebreather mask.
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Question 1 of 3
1. Question
What is the most likely underlying diagnosis?
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Question 2 of 3
2. Question
His ABG result showed:
- pH: 7.32, pCO2: 5.1, pO2: 19.2, sats 85%
- MethHb: 48.1%, HCO3: 21, BE: 0.8
- Lactate: 1.0
- Na: 137, K: 4.8
How would you treat this man? (Select all options that apply)
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Question 3 of 3
3. Question
After your treatment, your patient's saturations improve to normal and he is now alert and orientated. He tells you he has used poppers (alkyl nitrites) and is keen to leave the department. His blood gases show that his MetHb levels are now within normal limits.
What advice would you give him?
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