A patient has the following blood gases: PaCO2 33, pH 7.50, HCO3 23. Which of the following could NOT be the cause of this condition?

Aspirin toxicity

Fever

Anxiety attack

Chronic obstructive pulmonary disease (COPD)

Answer and Explanation

The Correct Answer is D

A. Aspirin Toxicity:
Effect on Blood Gases: Aspirin toxicity can cause respiratory alkalosis due to increased respiratory rate (hyperventilation), leading to a decreased PaCO2 and increased pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values (low PaCO2 and high pH), making it a possible cause.

B. Fever:
Effect on Blood Gases: Fever might cause hyperventilation, resulting in respiratory alkalosis with decreased PaCO2 and increased pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values.

C. Anxiety Attack:
Effect on Blood Gases: Anxiety attacks can lead to hyperventilation and subsequent respiratory alkalosis with low PaCO2 and high pH.
Relation to Given Blood Gases: It could potentially cause the observed blood gas values.

D. Chronic Obstructive Pulmonary Disease (COPD):
Effect on Blood Gases: COPD typically causes respiratory acidosis due to impaired gas exchange, resulting in elevated PaCO2 and decreased pH.
Relation to Given Blood Gases: COPD wouldn't typically cause the observed blood gas values of low PaCO2 and high pH.

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Correct Answer is D

Explanation

A. Respiratory acidosis:
This occurs when there is inadequate ventilation, leading to an accumulation of carbon dioxide (CO2) in the blood. In the context of a nasogastric tube attached to low suction, respiratory acidosis is not the primary concern. It is more associated with conditions like respiratory depression or lung diseases.

B. Metabolic acidosis:
Metabolic acidosis results from an excess of acid or a loss of bicarbonate. It is not the typical outcome of a nasogastric tube attached to low suction. Conditions like diarrhea or renal failure are more commonly associated with metabolic acidosis.

C. Respiratory alkalosis:
Respiratory alkalosis occurs when there is excessive loss of carbon dioxide from the body, often due to hyperventilation. This is not a typical consequence of a nasogastric tube attached to low suction.

D. Metabolic alkalosis:
Metabolic alkalosis is characterized by an excess of bicarbonate or a loss of acid. In the given context, with the nasogastric tube attached to low suction, there is a potential loss of gastric acid, contributing to metabolic alkalosis.

A. Urinalysis shows trace protein B. Hemoglobin A1C of 5.6% C. Fasting blood glucose of 110 mg/dL D. Urine ketones are negative

Correct Answer is B

Explanation

A. Urinalysis shows trace protein:
Explanation: While trace protein in the urine is generally better than higher levels, it doesn't provide a specific measure of blood glucose control. Protein in the urine can be an early sign of kidney damage in diabetes, but it doesn't directly indicate blood glucose control.

B. Hemoglobin A1C of 5.6%:
Explanation: Hemoglobin A1C (HbA1C) is a long-term indicator of blood glucose control. An HbA1C level of 5.6% is within the target range for individuals with diabetes and suggests good control of blood glucose over the past 2-3 months.

C. Fasting blood glucose of 110 mg/dL:
Explanation: Fasting blood glucose gives a snapshot of blood glucose at a specific moment. While 110 mg/dL is a fairly normal fasting level, it doesn't provide information about long-term control. A single fasting glucose measurement may not reflect overall glucose management.

D. Urine ketones are negative:
Explanation: Negative urine ketones indicate that the body is not currently using fat for energy. While this is a good sign in the moment, it doesn't give information about overall blood glucose control over time. Urine ketones can fluctuate based on various factors, including diet and activity level.

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A patient has the following blood gases: PaCO2 33, pH 7.50, HCO3 23. Which of the following could NOT be the cause of this condition?

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