Mrs. Kalen is a 70 year old female who has arrived into the ER due to persistent vomiting for two days now. She appears to be lethargic and weak and has myalgia. She is noted to have dry mucus membranes and her capillary refill takes >4 seconds. She is diagnosed as having gastroenteritis and dehydration. Measurement of arterial blood gas shows pH 7.5, PaO2 85 mm Hg, PaCO2 40 mm Hg, and HCO3 34 mmol/L. What would you interpret the acid-base disorder to be?
Uncompensated Respiratory Acidosis
Fully Compensated Metabolic Acidosis
Uncompensated Metabolic Alkalosis
Partially Compensated Respiratory Alkalosis
The Correct Answer is C
The pH value of 7.5 indicates alkalosis, as it is above the normal range of 7.35-7.45. The elevated bicarbonate (HCO3-) level of 34 mmol/L suggests metabolic alkalosis, as it is higher than the normal range of 22-28 mmol/L. The PaCO2 level of 40 mm Hg falls within the normal range of 35-45 mm Hg.
In this case, the primary disturbance is metabolic alkalosis, which is likely caused by vomiting leading to excessive loss of gastric acid (hydrogen ions) and chloride ions from the stomach. This loss of acid and chloride results in an imbalance of electrolytes and an increase in bicarbonate levels, leading to metabolic alkalosis.
The arterial blood gas results do not indicate any compensation. Compensation occurs when the body attempts to restore the pH balance by adjusting the respiratory or metabolic systems. In this case, there is no compensation observed because the PaCO2 level is within the normal range and not significantly altered.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Chemotherapy is a treatment modality used to target and destroy rapidly dividing cells, including cancer cells. It works by interfering with the cell division process, which is a characteristic of cancer cells. However, it is important to note that chemotherapy drugs can also affect normal, healthy cells in the body that undergo rapid division, such as cells in the bone marrow, hair follicles, and gastrointestinal lining. This is why chemotherapy can be associated with side effects like bone marrow suppression, hair loss, and gastrointestinal disturbances. While the molecular structure of DNA can be altered by certain chemotherapeutic drugs, this explanation is not comprehensive enough to encompass the overall mechanism of action of chemotherapy.
The statement that "cancer cells are susceptible to drug toxins" is partially true, as cancer cells are generally more vulnerable to the cytotoxic effects of chemotherapy drugs compared to normal cells.
Chemotherapy aims to disrupt the division and growth of cancer cells rather than promoting their division.
Correct Answer is ["A","C","D","F"]
Explanation
Muscle rigidity is a hallmark sign of malignant hyperthermia. It commonly affects the muscles of the jaw and upper chest.
Malignant hyperthermia can lead to rapid and shallow breathing, resulting in tachypnea. Malignant hyperthermia is characterized by a significant increase in body temperature, often exceeding 38.8°C (101.8°F).
Malignant hyperthermia can cause irregular heart rhythms or dysrhythmias, including tachycardia or arrhythmias.
The manifestations of hypertension and skin mottling are not typically associated with malignant hyperthermia. Hypertension (high blood pressure) is more commonly seen in conditions such as hypertensive emergencies or certain cardiovascular disorders. Skin mottling, which refers to irregular or patchy skin coloration, is not a specific manifestation of malignant hyperthermia.
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