Case of the Week: Acid-Base Disturbance #5
From AccessMedicine
Clinical Scenario
A 65-year-old successful businessman with hypertension is brought to the emergency department from home with hypotension and shortness of breath. He recently traveled back from Asia following a business trip. Since returning home, he's noted some lightheadedness and dyspnea with exertion, which has significantly progressed over the last 12 hours. His blood pressure on arrival is 90/50 mm Hg with a heart rate of 120 bpm. He takes amlodipine and hydrochlorothiazide (HCTZ) for his hypertension and maintains a 2-gram salt diet. His baseline creatinine is 0.8 mg/dL.
| Laboratory Data: | ||||
| ABG | Basic Metabolic Panel | |||
| pH | 7.50 | Na | 144 mEq/L | |
| PaCO2 | 22 mm Hg | K | 4.0 mEq/L | |
| PaO2 | 214 mm Hg | Cl | 98 mEq/L | |
| HCO3 | 18 mEq/L | CO2 | 17 mEq/L | |
| FIO2 | 0.60 | BUN | 44 mg/dL | |
| Cr | 1.9 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 alkalosis only
C - Metabolic acidosis and a respiratory acidosis
D - Metabolic alkalosis and a respiratory acidosis
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