Question

LS is brought to the emergency department for management of acute mushroom poisoning. Her respirations are slow and shallow, and she is nonresponsive. She is admitted to the critical care unit to be closely monitored for the development of respiratory failure and renal failure, which often accompany mushroom poisoning. Her urine output is decreased to about 20 mL/hr. Her laboratory values are serum K+ = 6.0 mEq/L; BUN 40; Creatinine 1.3mg/dl; arterial blood gases (ABGs): pH = 7.13, PaCO2 = 56 mm Hg, PaO2 = 89 mm Hg, and HCO3- = 18 mEq/L. .1. What is the most likely cause of LS’s potassium imbalance? Explain the role of the kidney in potassium excretion. What is the reason for LS’s low urine output? .Categorize and explain the probable cause of LS’s acid-base disorder?

Answer 1

1) THE PATIENT HAVE HYPERKALEMIA ( K- 6.0) DUE TO THE INTAKE OF MUSHROOM. _ MUSHROOM IS CONSIDERED AS MOST POTASSIUM RICH FOOD. _ IT CAN CAUSE FROM DECREASED RENAL EXCRETION LEADS TO EXCESSIVE ACCUMULATION OF POTASSIUM IN THE BLOOD. 2) POTASSIUM IS FILTERED BY THE GLOMERULUS AND REABSORBED BY PROXIMAL TUBULES.BUT MORE REGULARION IS TAKES PLACE IN COLLECTING DUCTS.KIDNEY IS THE MOST RESPONSIBLE ORGAN IN POTASSIUM MAINTENANCE. * 90% OF POTASSIUM IS EXCRETED THROUGH URINE. 3) _ MUSHROOM POISONING LEADS TO ACUTE KIDNEY INJURY. _ NEPHROTOXIC MUSHROOM POISONING IS THE CAUSE OF KIDNEY INJURY. _ IT MAY LEADS TO HIGH BUN VALUE AND HIGH IN POTASSIUM,UREA AND CREATININE. _ IT MAY LEADS TO IMPAIRED RENAL FUNCTIONING CAUSING LOW URINARY OUTPUT. 4) *THE PATIENT HAVE MIX METABOLIC AND RESPIRATORY ACIDOSIS DUE TO PH IS LOW (7.13( normal range-7.35-7.45) * METABOLIC ACIDOSIS IS RULE OUT BY LOW BICARBONATE (18-( NORMAL RANGE 22-26) * RESPIRATORY ACIDOSIS IS RULE OUT BY HIGH PaCO2( 56( Normal range-38-42)