A 78-year-old man is brough in from home after a 3-day history of diarrhea. His venous blood gas shows pH 7.27, HCO3 14 mmol/L, PCO2 28 mmol/L, K 2.6 mEq/L, Na 134 mEq/L, CI 113 mEq/L, Urea 70 mg/dl, Creatinine 5 mg/dl, and Albumin 4 mg/dl Which one of the following options would best explain his acid-base disorder?
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: C. Normal anion gap metabolic acidosis secondary to diarrhea
AG = 134 − (113 + 14) = 7 (normal) with albumin 4 (no correction) → non-AG metabolic acidosis. Winter: 1.5 × 14 + 8 = 29 ± 2, and PCO2 28 is appropriate, so there is no extra respiratory disorder (D wrong). Diarrhoea (bicarbonate loss) is the most common NAGMA cause. The raised creatinine has not produced a high AG (B wrong).
ليش كل خيار صح أو غلط
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A
ليش غلط
His anion gap is 134 − (113 + 14) = 7, which is normal; a similar lecture case (diarrhea, gap 10) is labelled NAGMA, not a high-gap acidosis.
✓ ABG⭐️⭐️.pdf · p. 3 -
B
ليش غلط
His calculated gap is 134 − (113 + 14) = 7 (normal), so there is no high-gap acidosis from renal failure; the matching diarrhea case is labelled NAGMA.
✓ ABG⭐️⭐️.pdf · p. 3 -
C
ليش صح
With a normal gap (7) and albumin 4 (no correction), diarrhea with bicarbonate loss gives a non-anion-gap metabolic acidosis, as in the matching lecture case.
✓ ABG⭐️⭐️.pdf · p. 3 -
D
ليش غلط
The gap is normal, and PCO2 28 is within Winter's range (1.5 × 14 + 8 = 29 ± 2), meaning a simple metabolic acidosis with appropriate secondary hypocapnia, not a second respiratory disorder.
✓ Step Up To Medicine 6th Edition 2024 (Acid-base imbalance).pdf · p. 6
- المصدر
- ABG⭐️⭐️.pdf · p. 3
Step Up To Medicine 6th Edition 2024 (Acid-base imbalance).pdf · p. 5 - المحاضرة
- Respiratory Failure & Acid–Base · Pulmonology · Module B
- ظهر في
- Respi bank