Acid-Base Disturbance Case #8
From AccessMedicine
Case:
A 50-year-old male patient with cirrhosis secondary to chronic alcoholism presents to the emergency department for encephalopathy. He hasn't been taking his prescribed lactulose at home. He has normal vital signs. He is mildly confused on exam, but he is in no distress. He takes lithium for bipolar disorder, as well as albuterol as needed.
| Laboratory Data: |
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| ABG |
Basic Metabolic Panel |
|||
| pH |
7.33 |
Na |
131 mEq/L |
|
| PaCO2 |
25 mm Hg |
K |
3.1 mEq/L |
|
| PaO2 |
100 mm Hg |
Cl |
113 mEq/L |
|
| HCO3 |
15 mEq/L |
CO2 |
15 mEq/L |
|
| BUN |
5 mg/dL |
|||
| Cr |
1.1 mg/dL |
|||
| Albumin |
1.0 g/dL |
|||
Question 1 of 5:
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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