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)

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