Case o f the Week: Acid-Base Disturbance #1
From AccessMedicine
A 44-year-old homeless person with schizophrenia and alcoholism presents to the emergency department with altered mental status and renal failure. He is intubated shortly after arrival due to an inability to protect his airway. There is no additional history available. He is tachypneic with a respiratory rate in the 30s prior to intubation.
| Laboratory Data: |
||||
| ABG |
Basic Metabolic Panel |
|||
| pH |
7.06 |
Na |
131 mEq/L |
|
| PaCO2 |
30 mm Hg |
K |
5.6 mEq/L |
|
| PaO2 |
80 mm Hg |
Cl |
98 mEq/L |
|
| HCO3 |
7 mEq/L |
CO2 |
7 mEq/L |
|
| BUN |
68 mg/dL |
|||
| Cr |
3.8 mg/dL |
|||
| Albumin |
2.0 g/dL |
|||
What is/are the primary acid-base disturbance(s) occurring in this case?
A – Metabolic acidosis only
B – Respiratory acidosis only
C – Metabolic acidosis and a respiratory acidosis
D – Metabolic alkalosis and a respiratory alkalosis
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