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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