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14th August 2024
You are asked to urgently review a patient on the ward who is acutely confused
You are asked to urgently review a patient on the ward who is acutely confused.
He is a 58-year-old man with a background history of hypertension and hypercholesterolaemia, who is independent at baseline and works for a hedge fund. He was admitted 2 days ago with a cavitating community acquired pneumonia requiring IV antibiotics. A sputum sample has grown Klebsiella pneumoniae.
Upon your arrival, he loses consciousness and starts exhibiting seizure activity.
An urgent arterial blood gas demonstrates:
| pH | 7.27 | (7.35-7.45) |
| pO₂ | 28.4 | (10-12) |
| FiO₂ | 60% | |
| pCO₂ | 5.7 | (4.5-6) |
| Na⁺ | 131 | (135-145) |
| K⁺ | 4.6 | (3.5-5.5) |
| HCO₃⁻ | 18.1 | (22-26) |
| Lac | 3.9 | (0-2) |
| Glu | 6.3 | (4-7.8) |
Which is the single most likely cause of his seizures?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
Complete Guide to Clinical Genetics ST3 Application and Recruitment (2027)
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Complete Guide to Paediatric Surgery ST3 Application and Recruitment in United Kingdom (2026)
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