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CASE HISTORY


Hb 11.5, WCC 4.3, Platelets 50.
Na 136, K 3.4, urea 6.2, creatinine 138.
PT (prothrombin time) >180, APTT (activated partial thromboplastin time) >240, INR 12.
Ca 2.1, Mg 0.4



(click for larger graph)

Hb 11.5, WCC 4.3, Platelets 50.
Na 136, K 3.4, urea 6.2, creatinine 138.
PT (prothrombin time) >180, APTT (activated partial thromboplastin time) >240, INR 12.

Hb 11.5, WCC 4.3, Platelets 50.
Na 136, K 3.4, urea 6.2, creatinine 138.

Diagnosis: meningococcal septicaemia.
Bloods sent for FBC, biochemistry, U&E, clotting.



(click for larger graph)

Diagnosis: meningococcal septicaemia.
Bloods sent for FBC, biochemistry, U&E, clotting.



(click for larger graph)

Diagnosis: meningococcal septicaemia.
Bloods sent for FBC, glucose, biochemistry, U&E, clotting.

15 year old  boy non-specifically unwell for a day.  Woke with a widespread purpuric rash and taken straight to hospital.

(click for larger graph)


ED assessment:
Temp 39.0, HR 120, RR 20, BP 90/60.
Alert no meningism; purpuric rash spreading.


  help

QUESTIONS ON CASE 4


  
  
Q 11 of 18: Which findings would indicate a favourable response to a fluid bolus?
(Choose all that apply)

Tachycardia settling Improved urine output Improved peripheral perfusion Blood pressure improving Base excess less negative Increased respiratory rate

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