Case of the Week: Acid-Base Disturbance #4
Clinical Scenario
A 70-year-old male with severe COPD presents to the emergency department, obtunded, with rapid shallow breathing. He is intubated in the emergency department. His wife reports that he has been experiencing worsening shortness of breath at home, with increased sputum production and some low-grade fevers. He is normotensive on admission to the intensive care unit.
| Laboratory Data: |
||||
| ABG |
Basic Metabolic Panel |
|||
| pH |
7.07 |
Na |
140 mEq/L |
|
| PaCO2 |
107 mm Hg |
K |
4.1 mEq/L |
|
| PaO2 |
55 mm Hg |
Cl |
93 mEq/L |
|
| HCO3 |
44 mEq/L |
CO2 |
45 mEq/L |
|
| FIO2 |
0.36 |
BUN |
15 mg/dL |
|
| Cr |
1.1 mg/dL |
|||
Question 1 of 6:
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 acidosis
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