A 47-year-old gentleman with a history of liver cirrhosis presented to the Emergency Department feeling unwell with a cough productive of green sputum. | Medibuddy
22nd June 2023

A 47-year-old gentleman with a history of liver cirrhosis presented to the Emergency Department feeling unwell with a cough productive of green sputum.

A 47-year-old gentleman with a history of liver cirrhosis presented to the Emergency Department feeling unwell with a cough productive of green sputum. On examination, he has crepitations of his right base. His bloods are as follows:

Result Reference range
Hb 117 g/L (Male 130-190 g/L)
WCC 24.9 x10⁹/L (3.6-11 x10⁹/L)
Neutrophils 20.8 x10⁹/L (1.8-7.5 x10⁹/L)
Sodium 131 mmol/L (133-146 mmol/L)
Potassium 4.2 mmol/L (3.5-5.3 mmol/L)
Urea 2.6 mmol/L (2.5-7.8 mmol/L)
Creatinine 54 μmol/L (59-104 μmol/L)
ALT 167 U/L (<50 U/L)
Bilirubin 64 μmol/L (<21 μmol/L)A
ALP 216 U/L (30-130 U/L)
Albumin 21 g/L 35-50 g/L

A VBG shows:

Result Reference range
pH 7.26 (7.35-7.45)
Chloride 104 mmol/L (95-108 mmol/L)
Bicarbonate 13.2 mmol/L (22-29 mmol/L)
Lactate 5.1 mmol/L (0.5-2.2 mmol/L)

Which is the calculated corrected anion gap, rounded up to one decimal place.

Select the SINGLE most appropriate option from the list below. Select ONE option only.

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