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15th August 2024
A 59-year-old woman with a history of small-cell lung carcinoma receiving chemotherapy
A 59-year-old woman with a history of small-cell lung carcinoma receiving chemotherapy presents following a seizure at home, with a further seizure noted in the Emergency Department. The seizures both lasted less than 1 minute and terminated spontaneously.
She is confused on assessment but is able to tell you that she has been feeling tired and unsteady on her legs for the last few days. She does not report any vomiting.
An urgent venous blood gas demonstrates:
| pH | 7.29 | (7.35-7.45) |
| pO₂ | 6.7 | (10-12) |
| pCO₂ | 5.6 | (4.5-6) |
| Na⁺ | 109 | (135-145) |
| K⁺ | 4.5 | (3.5-5.5) |
| HCO₃⁻ | 19.3 | (22-26) |
| Lac | 3.7 | (0-2) |
| Glu | 5.1 | (4-7.8) |
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