20
A 30-year-old woman comes to the emergency department because of shortness of breath and numbness and tingling of her fingers. If arterial blood gas values were ordered, results would most likely show which of the following?
Po2 Pco2 pH HCO3−
(mm Hg) (mm Hg) (mEq/L)
A) 70 60 7.25 27
B) 40 60 7.37 33
C) 90 40 7.40 24
D) 110 25 7.50 19
E) 40 60 7.51 27
We just can't miss these questions
... I was checking some books and then got caught with NEJM, have you seen their interactive patients? It's awesome!!! Kind of CCS but looots of explanations, too much I think, but it was cool! Wanna look?
http://www.nejm.org/multimedia/interactive-medical-case
Ok, back to this qs ... a little review...
Respiratory Alkalosis
Example:
Clarence H, a 68-year-old male, is admitted for an Anxiety Attack. He almost passed out at his wife's funeral. His ABG values present as:
pH = 7.50
PaCO2 = 30
HCO3 = 24
Respiratory alkalosis is defined by a pH greater than 7.45 and a CO2 less than 35 mm Hg as average. Any condition that results in hyperventilation can lead to respiratory alkalosis. This can result from anxiety attacks, fear, pain, early asthma, CNS lesions, pneumothorax and pulmonary embolism. Disease states that may increase metabolic demands may also result in hyperventilation. This includes sepsis, fever, thyrotoxicosis, pregnancy, excessive mechanical ventilation.
So....
Our options:
---Po2 -- Pco2 -- pH -- HCO3−
A) 70 --- 60 ---- 7.25 --- 27 X (Low pH)
B) 40 --- 60 ---- 7.37 --- 33 X (Low pH)
C) 90 --- 40 ---- 7.40 --- 24 X (Low pH)
D) 110 -- 25 ---- 7.50 --- 19 Could be
E) 40 --- 60 ----- 7.51 --- 27 Could be, but PO2 is too low under the basement
I think I would stick to D