April 2019 Critical Care Case of the Month: A Severe Drinking Problem

Monday, April 1, 2019 at 8:00AM
Rick Robbins, M.D. in anion gap, diagnosis, ethylene glycol, fomepizole, mental status, metabolic acidosis, mudpiles, oxalate, stroke, treatment

Francisco J. Marquez II MD

Department of Pulmonary and Critical Care Medicine

Banner University Medical Center/University of Arizona – Phoenix

Phoenix, AZ USA

 

History of Present Illness

A 55-year-old Caucasian man, presented to an outside hospital with altered mental status.

Past Medical/Social History

• Severe alcohol and intermittent fentanyl abuse
• Homelessness

Physical Exam

• Hypothermic and hypertensive.
• Patient encephalopathic without any acute deficits
• Pupils are normal sized and react to light

Which of the following should be obtained or done in his initial evaluation? (Click on the correct answer to proceed to the second of six pages)

1. CBC
2. Electrolytes
3. Give naloxone (Narcan®) and glucose
4. 1 and 3
5. All of the above

Cite as: Marquez FJ II. April 2019 critical care case of the month: A severe drinking problem. Southwest J Pulm Crit Care. 2019;18(4):67-73. doi: https://doi.org/10.13175/swjpcc003-19 PDF 

Article originally appeared on Southwest Journal of Pulmonary, Critical Care and Sleep (https://www.swjpcc.com/).