patient in coma, what the cause of his coma? PH 7.2 (7.35-7.45) Pco2 : 27 (35-45) Hco3: 18 (22-28)
سؤال مجاني 7 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: A. metabolic acidosis
Low pH with low HCO3 (18) is a primary metabolic acidosis, which explains the coma. Winter's formula predicts a PCO2 of about 35 (1.5 x 18 + 8); the measured 27 is lower, which points to an additional respiratory alkalosis. The primary disorder is still metabolic acidosis, since a primary respiratory alkalosis would raise the pH.
ليش كل خيار صح أو غلط
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A
ليش صح
pH is low and HCO3 is low (18), moving in the same direction, so the primary disorder is metabolic acidosis.
✓ Pulmonology 🫁.pdf · p. 21 -
B
ليش غلط
Alkalosis needs a high pH (> 7.45); this patient's pH is 7.2, which is acidemia.
✓ Pulmonology 🫁.pdf · p. 21 -
C
ليش غلط
Respiratory acidosis has a high PCO2 as the primary change; here PCO2 is low (27) and HCO3 is low, so it is not respiratory acidosis.
✓ Pulmonology 🫁.pdf · p. 21 -
D
ليش غلط
A primary respiratory alkalosis would come with a high pH, not 7.2. The low PCO2 is the respiratory response to metabolic acidosis; since 27 is below the expected 1.5 × 18 + 8 ± 2 (33 to 37), there is likely an additional respiratory alkalosis, but it is not the primary disorder.
✓ Pulmonology 🫁.pdf · p. 21
- المصدر
- Pulmonology 🫁.pdf · p. 21
- المحاضرة
- Respiratory Failure & Acid–Base · Pulmonology · Module B
- ظهر في
- Respi bank · Respi bank · EOM B40