Question:

A 30 year old man is admitted to hospital in a state of reduced consciousness(Glasgow coma scale 9)with froth coming out of his mouth and laboured respiration. according to his family members he was found collapsed in his room 1 hour ago. He is otherwise healthy man taking no regular medications. a strong pungent garlic like odor is apparent and is found coming from the patients body. The patient has no past history of psychiatric illness.

Arterial blood gas results on high flow oxygen

PaO2         55mmHg

PaCo2         23mmHg

HCO3-         24mmol/l

H+            34nmol/l

What is the differential diagnosis

What examinations can youper form

How will you treat this patient