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Browsing case: Pediatric intoxication
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1. A 13 year old girl has a fight with her mom and in protest, drinks about 125 mL of windshield washer fluid. She is in the emergency room, is stable and neurologically appropriate. The following blood work is ordered:
Na 135 mmol/L K 4.5 mmol/L
Cl 103 mmol/L bicarbonate 21 mmol/L
Creatinine 56 mcmol/L
Urea 4.7 mmol/L
Glucose 5.2 mmol /L
pH 7.35 pCO2 39 mm Hg
Serum Osmolality 365 mOsm/kg
What is the osmolar gap?
Responses:
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16
20
76
86
Explanation:
Osmolar gap = Measured - calculated osmolality
Measured Osm = 365
Calculated Osm = 2(135) + 2(4.5) + 4.7 + 5.2 = 289
365-289 = 76