AccessMedicine's Case of the Week: Acid Base Disturbance Case #12
From AccessMedicine
Case:
A 70-year-old male with congestive heart failure is transferred to the intensive care unit with worsening shortness of breath. His exam demonstrates inspiratory crackles throughout the bilateral lung fields, and he is hypoxemic requiring a partial re-breather mask. He is hypotensive to 80/30 mm Hg and his extremities are edematous and cold. You review his chart and his last echo shows an ejection fraction of 15%.
| Laboratory Data: |
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| ABG |
Basic Metabolic Panel |
|||
| pH |
7.24 |
Na |
129 mEq/L |
|
| PaCO2 |
19 mm Hg |
K |
5.6 mEq/L |
|
| PaO2 |
66 mm Hg |
Cl |
80 mEq/L |
|
| HCO3 |
13 mEq/L |
CO2 |
10 mEq/L |
|
| BUN |
44 mg/dL |
|||
| Cr |
1.9 mg/dL |
|||
| Albumin |
2.0 g/dL |
|||
Question 1 of 4:
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
Click HERE to answer the questions and complete the progressive case!
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