“Beep, beep, beep” – the one sound you dread to hear at 3 AM. As you get up from what you thought might be a few “clutch hours” of precious sleep, you see the numbers “6666” on your beeper – and your heart sinks… It’s the ER with your 7th admission of the night. Sleep deprived and bleary eyed, you drag yourself down to meet your 86 year old female patient from the nursing home with presumed urosepsis. But there’s something different about this case. You notice that her electrolytes are off – and not what you’d expect from a uroseptic patient. You note that instead of being acidotic as you might expect, she’s alkyotic. And it’s 3 AM…
