Pathology EMQ

Name: Saira Waraich

Theme: Acid-Base Handling

 

OPTION LIST

 

A	Metabolic acidosis	I	Respiratory acidosis with metabolic compensation
B	Metabolic acidosis with respiratory compensation	J	Respiratory alkalosis
C	Metabolic alkalosis	K	Respiratory alkalosis with metabolic compensation
D	Metabolic alkalosis with respiratory compensation	L
E	Mixed metabolic & respiratory acidosis	M
F	Mixed metabolic & respiratory alkalosis	N
G	Normal acid-base status	O
H	Respiratory acidosis	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 16 year old girl with fever, cough, and diffuse crepitations on auscultation of the lungs. Her arterial blood gas results show:

            pH 7.3     PaO2 9.5 kPa      PaCO2 7.2 kPa       HCO3- 25 mmol/L

 

2.  A 25 year old student who has been vomiting excessively after a trip abroad.

            Blood gas results:

            pH 7.47     PaO2 11 kPa       PaCO2 5.2 kPa     HCO3- 30 mmol/L

 

3.  A 37 year old woman who has had a panic attack.

            Blood gas results:

            pH 7.48     PaO2 11.5 kPa    PaCO2 4.2 kPa     HCO3- 24 mmol/L

 

4.  An 82 year old man, admitted to hospital 3 weeks ago, with a 5 day history of diarrhoea.         His stool cultures are positive for Clostridium difficile. Blood gas results:

            pH 7.35     PaO2 10.9 kPa   PaCO2 3.9 kPa     HCO3- 18 mmol/L

 

5.  A 46 year old man who has been found unconscious after an RTA. He has lost a lot of blood and is hypotensive.

5.        Blood gas results:

            pH 7.2      PaO2 10.7 kPa    PaCO2 4.9 kPa    HCO3- 15 mmol/L

He also has an increased anion gap at 24 mmol/L.

 

 

ANSWERS

1 H

2 C

3 J

4 B

5 A

Option K is unlikely to occur in real life, as it means that someone hyperventilates for long enough (days) for a metabolic compensation to occur.