Your Name: Hina Pathak

Theme: Acid Base Handling

 

OPTION LIST

 

A

Acute respiratory alkalosis with co-existent metabolic acidosis

I

 

B

Metabolic acidosis

J

 

C

Metabolic alkalosis with compensatory hypoventilation

K

 

D

Respiratory alkalosis

L

 

E

Respiratory acidosis

M

 

F

Compensatory metabolic alkalosis

N

 

G

Metabolic alkalosis

O

 

H

Compensated respiratory alkalosis

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. An elderly man was admitted to hospital in a confused state. He was dyspnoeic and had a cough productive of sputum. He was unable to give a coherent history but one of the casualty officers knew him to be an insulin-dependent diabetic patient with a long history of chronic bronchitis. Arterial blood: H+ - 66nmol/L, pH – 7.18, pCO2 – 7.4kPa

 

 

2. A young woman was admitted to hospital 8 hours after she had taken an overdose of aspirin. Arterial blood: H+ - 30nmol/L, pH – 7.53, pCO2 – 2.0kPa

 

 

3. A young woman was admitted to hospital unconscious, following a head injury. A skull fracture was demonstrated on radiography and a CT scan revealed extensive cerebral contusions. The respiratory rate was increased, at 38/min. 3 days after admission, the patient’s condition was unchanged. Arterial blood: H+ - 36nmol/L, pH – 7.44, pCO2 – 3.6kPa, Bicarbonate – 19mmol/L

 

 

4. A 45 year old man was admitted to hospital with a history of persistent vomiting, He had a long history of dydpepsia but had never sought advice for this, preferring to treat himself with proprietary remedies. On examination, he was obviously dehydrated and his respiration was shallow. Arterial blood: H+ - 28nmol/L, pH – 7.56, pCO2 – 7.2kPa, Bicarbonate – 45mmol/L. Serum: Na+ - 146, K+ - 2.8, Urea – 34.2. A barium meal showed pyloric stenosis, thought to be due to scaring caused by peptic ulceration.

 

 

5. A young man sustained injury to the chest in a road traffic accident. Effective ventilation was compromised by a large flail segment. Arterial blood: pO2 – 8kPa, pCO2 – 8kPa, pH – 7.24, H+ - 58nmol/L, Bicarbonate – 25mmol/L

 

 

ANSWERS

1. E

2. A

3. H

4. C

5. E