Pathology EMQ template.

Name: Erik Skyllberg

Candidate number:

Theme: ACID-BASE HANDLING

 

OPTION LIST

 

A

Metabolic Acidosis with Respiratory Compensation

I

Mixed Picture: Respiratory Alkalosis and Metabolic Alkalosis

B

Metabolic Acidosis, increased anion gap

J

Respiratory Acidosis

C

Metabolic Acidosis, normal anion gap

K

Respiratory Acidosis with Metabolic Compensation

D

Metabolic Alkalosis

L

Respiratory Alkalosis

E

Metabolic Alkalosis with Respiratory Compensation

 

 

F

Mixed Picture: Respiratory Acidosis and Metabolic Acidosis

 

 

G

Mixed Picture: Respiratory Acidosis and Metabolic Alkalosis

 

 

H

Mixed Picture: Respiratory Alkalosis and Metabolic Acidosis

 

 

 

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. Björn, a 16-year-old type I Diabetes Mellitus sufferer, forgot to take his insulin this morning and before he knows it, he is rushed to the hospital. On arrival in A&E, he is likely to show this acid-base disturbance.

 

2. Agnetha, a 34-year-old medical secretary with a history of psychiatric admissions, has just been told by the management that she will be made redundant because of recent cuts in funding. She immediately starts to think about the overdue tuition fee payments for her two children; she starts feeling faint and begins to breathe heavily. The subsequent acid-base disturbance is helped by rebreathing into a paper bag.

 

3.  Later that same day, Agnetha feels she cannot cope with the prospect of losing her job and decides to end her life by swallowing 50 tablets of aspirin. As one of her children arrives home early from school, he finds her on the toilet floor and immediately calls for an ambulance. Her arterial blood gases are likely to show this acid-base disturbance on arrival in A&E.

 

4. Benny, a 64-year old ex-smoker with previous ITU admissions for his lung condition has returned breathless to the ward. His arterial blood gases on room air showed:

 

pH 7.34; pCO2 9.4 kPa; pO2 7.7 kPa; HCO3- 36.8 mmol L-1

 

This arterial blood gas result is consistent with this acid-base disturbance.

 

5. Anni-Frid, a three-week old infant, was brought in to A&E by her worried mother after several bouts of projectile vomiting over the past four hours. Her arterial blood gases are likely to show this acid-base disturbance.

 

 

 

ANSWERS

1. B

2. L

3. H

4. K

5. D