An 80-year-old woman presents to emergency department with a two-day history of persistent vomiting. She is lethargic and has myalgia. Her mucous membranes are dry and her capillary refill is prolonged. She is diagnosed as having gastroenteritis and dehydration, Her ABG shows: PH 7.5. PaO2 85 mmHg (normal 80-100), PaCO2 43 mmHg (normal 35-45), and HCO3 37 mEq/L (normal 22-26). What acid-base disorder is for this patient?
سؤال مجاني 5 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: A. Uncompensated metabolic alkalosis
High pH with high HCO3 (37) from vomiting is a metabolic alkalosis. Appropriate compensation would raise PCO2 by about 7 for every 10 rise in HCO3 (expected around 49), but PCO2 is a normal 43, so there is no compensation. A very similar lecture case (vomiting, PCO2 43) is labelled uncompensated metabolic alkalosis.
ليش كل خيار صح أو غلط
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A
ليش صح
pH is high and HCO3 is high (metabolic); a near-identical lecture case with vomiting, PCO2 43 and a high HCO3 is labelled uncompensated metabolic alkalosis.
✓ ABG⭐️⭐️.pdf · p. 4 -
B
ليش غلط
Fully compensated means a normal pH despite abnormal PCO2 and HCO3; here the pH is 7.5, still alkalemic, so it is not fully compensated.
✓ Pulmonology 🫁.pdf · p. 21 -
C
ليش غلط
In respiratory disorders PCO2 moves opposite to pH; here PCO2 is a normal 43 while HCO3 (37) follows the high pH, so the disorder is metabolic.
✓ ABG & A-a gradient.pdf · p. 1 -
D
ليش غلط
Acidosis means a low pH (< 7.35); this patient's pH is 7.5, which is alkalosis.
✓ ABG & A-a gradient.pdf · p. 1 -
E
ليش غلط
Acidosis means a low pH (< 7.35); this patient's pH is 7.5 (> 7.45), which is alkalosis.
✓ Pulmonology 🫁.pdf · p. 21
- المصدر
- ABG⭐️⭐️.pdf · p. 4
Pulmonology 🫁.pdf · p. 21 - المحاضرة
- Respiratory Failure & Acid–Base · Pulmonology · Module B
- ظهر في
- Respi bank