Brain death Quiz: Ace Your Exams
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A 32-year-old individual is reevaluated in the intensive care unit for ongoing management following cardiopulmonary arrest after being found unresponsive in an apartment 48 hours ago. Past medical history is unknown. A urine drug screen on arrival to the emergency department is negative. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 12/min by mechanical ventilation, and blood pressure is 130/85 mmHg. The patient is intubated and not receiving intravenous sedation. The patient remains unconscious without localizing movements in response to painful stimuli. There are intermittent arm flexion and arm-crossing movements. Brainstem reflexes are absent. Deep tendon reflexes are present bilaterally. Computed tomography (CT) of the head shows loss of gray-white matter differentiation. Current laboratory values are shown below. The treating physician is planning to perform apnea testing. Which of the following findings prohibits the physician from confirming the suspected diagnosis at this time?
| Laboratory value | Result |
| Serum chemistry | |
| Sodium | 113 mEq/L |
| Potassium | 3.4 mEq/L |
| Chloride | 95 mEq/L |
| Creatinine | 1.9 mg/dL |
| Albumin | 3.2 g/dL |
| BUN/Cr | > 20 |
| Toxicology | |
| Serum ethanol | 0 mg/dL |
| Acetaminophen level | 5 mcg/mL |
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