Pathology EMQ template.

Name: Arvinder Sood

Theme: Acid-Base handling

 

OPTION LIST

 

A	Metabolic acidosis	I	Respiratory alkalosis
B	Metabolic acidosis with respiratory compensation	J	Respiratory alkalosis with metabolic compensation
C	Metabolic alkalosis	K
D	Metabolic alkalosis with respiratory compensation	L
E	Mixed respiratory and metabolic acidosis	M
F	Mixed respiratory and metabolic alkalosis	N
G	Respiratory acidosis	O
H	Respiratory acidosis with metabolic compensation	P

 

 

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. A 21 year old medical student presents to A+E with heavy, sighing breathing, palpitations and dizziness. ABG results reveal: pH 7.58, pCO₂ 2.1 kPa, p0₂ 16 kPa. 

 

 

2. A 18 year old man presents semi-conscious to A+E. He is known to have a history of insulin-dependent diabetes. He takes deep breaths and his breath smells ketotic. ABG results reveal: pH 7.0. pCO₂ 2.2 kPa, pO₂ 12.2 kPa and HCO₃^-   4.0mM.

 

 

3. A middle-aged gentleman, accompanied by his wife, presents to A+E with vomiting and signs of dehydration. ABGs reveal: pH 7.38, pCO₂ 2.0 kPa, pO₂ 18 kPa, HCO₃^-  9.0mM. 

 

 

4. A 5-month old child is admitted to Paediatric A+E with a 2-day history of projectile vomiting. ABGs reveal pH 7. 58, pCO₂ 6.1 kPa, pO₂ 15Kpa ; bicarbonate (HCO3)=42mM and base excess of +20 mmol.

 

 

5. A 36 year old woman is brought to A+E by ambulance. She complains of acute onset of shortness of breath and atypical chest pain. On examination, she is anxious with a respiratory rate of 30 breaths per min. ABGs show: pH 7.55, pCO₂ 3.2 kPa, pO₂ 14kPa, HCO₃^- 21.

 

 

 

ANSWERS

1.  I

2. A

3. B

4. C

5. I