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Monday, 06 February 2012
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10 Year Old Boy with Vomiting
A previously well 10 year old boy presented to the emergency department following a 6 hour period of vomiting. His parents say that he has been feeling generally unwell for the last week and has lost some weight. On examination he is found to have "sighing" hyperventialtion and to have a reduced level of consciousness - only responding to a sternal pressure by moaning. Urgent blood tests show the following:

 

Blood test results
Haematology Biochemistry Venous Blood Gas
Hb 17.5 g/dl Na 136 pH 7.06
WBC 23.4 x 109/l K 6.4 Bicarb 9.2
Plt 429 Ur 12.5 Base Excess -14.8
  Cr 112  
  Glucose 33.5 mmol/l  

Q1. What is the diagnosis?

Q2. Why is he hyperventilating?





 
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