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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