Chapter·PhysiologyAcid-base balance

Respiratory alkalosis mechanisms and compensationDownloads

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1

A 24-year-old woman presents to the emergency department after she was found agitated and screaming for help in the middle of the street. She says she also has dizziness and tingling in the lips and hands. Her past medical history is relevant for general anxiety disorder, managed medically with paroxetine. At admission, her pulse is 125/min, respiratory rate is 25/min, and body temperature is 36.5°C (97.7°F). Physical examination is unremarkable. An arterial blood gas sample is taken. Which of the following results would you most likely expect to see in this patient?

ApH: increased, HCO3-: increased, Pco2: increased

BpH: decreased, HCO3-: decreased, Pco2: decreased

CpH: decreased, HCO3-: increased, Pco2: increased

DpH: increased, HCO3-: decreased, Pco2: decreased

EpH: normal, HCO3-: increased, Pco2: increased

2

A 66-year-old man is brought to the emergency department by his daughter because of 3 days of fever, chills, cough, and shortness of breath. The cough is productive of yellow sputum. His symptoms have not improved with rest and guaifenesin. His past medical history is significant for hypertension, for which he takes hydrochlorothiazide. He has a 30-pack-year history of smoking. His temperature is 38.9 C (102.0 F), blood pressure 88/56 mm Hg, and heart rate 105/min. Following resuscitation with normal saline, his blood pressure improves to 110/70 mm Hg. His arterial blood gas is as follows: Blood pH 7.52, PaO2 74 mm Hg, PaCO2 28 mm Hg, and HCO3- 21 mEq/L. Which of the following acid-base disturbances best characterizes this patient's condition?

AMetabolic acidosis

BRespiratory acidosis

CRespiratory alkalosis

DNormal acid-base status

EMetabolic alkalosis

3

A 24-year-old male is brought in by ambulance to the emergency department after he was found unresponsive at home for an unknown length of time. Upon arrival, he is found to be severely altered and unable to answer questions about his medical history. Based on clinical suspicion, a panel of basic blood tests are obtained including an arterial blood gas, which shows a pH of 7.32, a pCO2 of 70, and a bicarbonate level of 30 mEq/L. Which of the following is most likely the primary disturbance leading to the values found in the ABG?

ARespiratory acidosis

BMetabolic alkalosis

CRespiratory alkalosis

DMetabolic acidosis

EMixed alkalosis

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