A 68-year-old woman with a history of COPD, presents to the emergency department with chest pain and shortness of breath. On examination there are widespread crackles and you notice ankle edema. Arterial blood gases showed: PH 7.20 (7.35-7.45),PCO2 49 mmHg (35–45), HCO3 17 mEq/L (22-26), BE: -8 (-2 to +2). This indicates:
سؤال مجاني 10 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
الإجابة: C. Mixed respiratory and metabolic acidosis
pH 7.20 is acidemia. PCO2 is high (moves opposite to pH), so there is respiratory acidosis. HCO3 is low (moves with pH), so there is also metabolic acidosis. Compensation for respiratory acidosis would raise HCO3, so a low HCO3 (and BE -8) means two primary processes: mixed respiratory and metabolic acidosis.
ليش كل خيار صح أو غلط
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A
ليش غلط
A metabolic alkalosis would need a high HCO3, since HCO3 follows pH in metabolic disorders. Her HCO3 is low (17) with a low pH, so the metabolic part is an acidosis.
✓ ABG & A-a gradient.pdf · p. 1 -
B
ليش غلط
Respiratory alkalosis would need a low PCO2, but hers is 49, above the normal 35-45, so it moves opposite to the low pH, meaning respiratory acidosis.
✓ ABG & A-a gradient.pdf · p. 1 -
C
ليش صح
pH is low; PCO2 is high (opposite to pH) = respiratory acidosis, and HCO3 is low (follows pH) = metabolic acidosis, so both are present.
✓ ABG & A-a gradient.pdf · p. 1 -
D
ليش غلط
A pH of 7.20 is below 7.35, which means acidosis; alkalosis is defined by pH above 7.45.
✓ ABG & A-a gradient.pdf · p. 1
- المصدر
- ABG & A-a gradient.pdf · p. 1
- المحاضرة
- COPD Exacerbation · Pulmonology · Module B
- ظهر في
- Respi bank