Question - Need help with the following Clinical Biochemistry Case Studies.
CASE 1: A 7-year-old boy was admitted unconscious to a casualty department. On examination he was found to be hyperventilating. He had inadvertently consumed ethylene glycol antifreeze, which he had found in his parent's garage stored in a lemonade bottle. Blood results were as follows.
PLASMA
Sodium 134mmol/L(135-145)
Potassium 6.0mmol/L (3.5-5.0)
Bicarbonate 10mmol/L (24-32)
Chloride 93mmol/L(95-105)
Glucose 5.3mmol/L(3.5 -6.0)
ARTERIAL BLOOD GASES
pH 7.2 (7.35-7.45)
paCo2 3.8kPa (4.6-6.0)
PaO2 13.1kPa (9.3-13.3)
MY QUESTION: It is said that the patient is suffering from METABOLIC ACIDOSIS but why isn't it RESPIRATORY ALKALOSIS since hyperventilation is a sign of respiratory alkalosis? Please Kindly explain. Thank you
CASE 2: 75 years of age man with dyspnea. congestive heart failure, edema
Test results:
Na 123mEq/L (135-147)
K 4.1 mEq (3.5-5.0)
Cl 90mEq/L (22-28)
BUN 30mg/dL (8-18)
Glucose 100mg/dL (70-110)
QUESTIONS:
1. What treatment should be used?
2. Why is BUN increased?