A chronic alcoholic is brought into the Emergency Department vomiting and compla

Question

A chronic alcoholic is brought into the Emergency Department vomiting and complaining of abdominal pain. Overall this patient looks really sick. The blood panel and ABG come back as follows:

pH = 7.40                                             Na+ = 137                   Urines

Paco2 = 41                              K+ = 3.8                       Ketones +3

Pao2 = 85                                Cl- = 90                        very yellow

HCO3- = 22                              HCO3- = 22

                                                            Glu = 138

                                                            BUN = 20

List two primary issues and explain what you would expect.  Write a few sentences discussing the physiology involved in this case.

Explanation / Answer

In the above case it may suspect that patient is having alcoholic ketoacidosis.this results because of excessive consumption of alcohol for long time. Nausea vomiting abdominal pain occurs in about 60-75% of cases. Dizziness, sickness, dyspnea also observed in some patients. Symptoms mainly attributed to alcoholic gastritis or pancreatitis.

Physiology of involved case.,when some person is chronic drinker it increases tolerance for alcohol, alcohol broken down to quickly.alcohol withdrawal syndrome seen when such person suddenly stops drinking and mild symptoms like sweating, irritability, vomiting seen. Because liver play main role in detoxification of alcohole there are 3 conditions seen they are: first fatty liver then hepatitis finally cirrhosis.

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