AccessMedicine's Case of the Week: Acid-Base Disturbances: Clinical Scenario #32
A 44-year-old male with alcoholism and a history of IV drug abuse presents with encephalopathy from home. He has been taking over-the-counter anti-inflammatory medications for a pinched nerve over the last few days. His vitals are blood pressure 100/60 mm Hg, heart rate of 123 bpm, temperature 102.4°F, respiratory rate 28 breaths/minute, saturation 95% on room air. He takes spironolactone, furosemide, propranolol, and rifaximin at home. A CT scan of the head is negative. LP puncture is also negative.
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Laboratory Data: |
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ABG |
Basic Metabolic Panel |
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pH |
7.22 |
Na |
131 mEq/L |
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PaCO2 |
20 mm Hg |
K |
5.5 mEq/L |
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PaO2 |
100 mm Hg |
Cl |
112 mEq/L |
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HCO3 |
8 mEq/L |
HO2 |
8 mEq/L |
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BUN |
29 mg/dL |
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Cr |
2.3 mg/dL |
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Glucose |
89 mg/dL |
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Albumin |
1.5 g/dL |
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EtOH |
0 mg/dL |
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Question 1 of 7: 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
E - Metabolic alkalosis
F - Respiratory alkalosis
Click HERE to answer the questions and complete the case!
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