Authors: Amy Jones, Hayley Mistri / Editors: Mark Winstanley / Reviewer: Kathryn Blackmore, Ciaran Mackle / Code: EnC4, EnP2, SLO1 / Published: 14/11/2021 / Reviewed: 26/04/2025
A 62-year-old lady presents with a 2 week history of feeling generally unwell. She has felt intermittently dizzy, nauseous and lethargic. She has a past medical history of type 2 diabetes mellitus, hypertension and CKD. Her GP has done some bloods one week previously, which had shown a deterioration in her renal function from baseline, and so they had stopped her Metformin.
She presents to the Emergency Department (ED) following a severe attack of nausea and dizziness followed by collapse at home. On arrival her observations are: HR 93 BP 106/78 sats 100% air RR 22.
A venous blood gas taken on arrival shows a pH of 7.30
Glucose unrecordably high. Ketones are 0.03
Na 156 HB 111 Glucose 67
K 4.8 WCC 7.34
Ur 11.4 PLT 99
Cr231 CRP <5
14 responses
Practical and concise.
HHS is a ED Diagnosis and carries a higher mortality, Thank you for making it simple and sweet
Good case learning. Indeed sweet and salty!
Excellent. Covered key take-home messages
very confusing with DKA but explained and differentiated beautifully
Thanks this was good
Concise
Excellent revision case for HHS.
nice case review
excellent
Just what is needed in ED
Seen regularly in ED
Great Revision
Yes exactly sweet &salty
Thank you