fongch
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A middle-aged man with a history of epilepsy is brought to the ER following a grand mal seizure. He is confused, but respond slowly to commands. Laboratory tests reveal a blook pH of 7.14, PCO2 of 45 mmHg, and HCO3 13mEq/L. Which of the following conditions is most likely present in this patient?
A. Metabolic acidosis w/ respiratory compensation
B. Metabolic acidosis w/o compensation
C. Metabolic alkalosis w/o compensation
D. Respiratory acidosis w/ metabolic compensation
E. Respiratory acidosis w/o compensation.
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| drpkaur
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b...
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| fongch
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Can you explain a little bit more?
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| drpkaur
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See ph and bicarbonates are both decreased telling that it's case of metabolic acidosis...As Pco2 is 45 in this case and in metabolic acidosis with respiratory compensation PCo2 should decrease as a result of hyperventilation but here it's not decreased means no compensation yet..correct me if i am wrong..
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| pocas
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yes your explain is very good, when you see that the ph is down you have to see at first CO2 in this case is normal , then you see the HCO3 and it is alter so
IT is metabolic acidosis without compensation because the CO2 stay in normal range
the answer is B
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| fongch
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I agree with pocas in that you should read PCO2 right after you notice the pH is down, however ,how can you count 45 as normal PCO2?
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| drpkaur
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fongch what's the answer then???plz
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| fongch
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The Kapland's answer is B. But I have questions as I stated in my previous post.
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| khorshid
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you can't consider 45 a nl pco2, but the decrease in hco3 is more proportionate with acidosis we have here, another hint is that acidosis happened after grand mal seizure so it is lactic acidosis and can't be respiratory acidosis, correct me if I am wrong.
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| Ivil
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Normal Range for PCO2 is 33 - 45 mm Hg....
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| MRMAVERICK
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ya b-ivil is right abt normal range and dr pkaur has explained the rest
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| MRMAVERICK
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