GoodGirl
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I really don't like this kind of question, I will be doomed on the exam..... what about you?
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| new_n_lost
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OK here goes nothing in under one minute i came up with the answer of Choice B which seemed suitable at the time cos Metformin + Alcohol = Lactic Acidosis which leads to tissue hypoxia . But then it got me thinking that this cant be Tissue hypoxia cos PO2 value is 90mmHg. so by exclusion i am stuck with 2 choices, which are C and E. For a massive anemia or life threatening one Hb should somewhere around 6g/dl.
and i choose C dont ask me why but somehow i have a feeling that much of a severe anemia would have brought him to the Hospital long before.
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| new_n_lost
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Ok here is the fun part why do i have a feeling that i was right the first time. but still sticking to C
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| acintya
FOCUS on your Goal!
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Ugh, such questions make me sooo uncomfortable....but its good to scratch the head 
agree with NNL: low pH, low pCO2 (therefore not ans b)+ Metformin + alcohol = metabolic acidosis....narrowed it down to C and E.
But with tissue hypoxia, you would left shift the O2 binding curve: decreased P50, as it gets more difficult for tissues to extract the O2, so I will go with Ans E.
what about the respiratory exchange rate (RER) which is 1. Does it have any significance? still confused tho....great question GG!
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| acintya
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ok, I just realized that with left shift of O2 curve, you would have alkalosis, but here we have acidosis..... so maybe your gut feeling was right NNL....maybe it is C....
GG, please help!!
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| GoodGirl
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Hello NNL & Ac, 
Here is the attached explanation, with my nonfunctional brain ( slept only 4 hours last night ), don't want to know my opinion about this Q ! Makes me  .
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| GoodGirl
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I really want to see myself answering this kind a question under the pressure of time ! 60 sec and move on ..... ( Please NNL, tell me, that you did not see them on your exam ) .
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| acintya
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GG: double
NNL--:thumbs UP:
Ok, so that's where the R had to be used.....Thanks GG, I need to digest this some more...
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| new_n_lost
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GG the only thing which for me stuck out in this question was PaCO2 was the lowest and u have acidosis while the PaO2 is 90mmHg so there is something which i m missing highlighting the only points in the question which were
1. Respiratory co efficient
2. the pH and PaCO2 values.
After one hour last night it occured to me or rather struck me that respi quotient wouldnt have been mentioned unless they were looking for something specific. Though i didnt arrive at my answer through that but now knowing the answer, I can only say onething that If in the real exam you find a question looking quite tough then you are only missing the point of the question and if you find a question easy then please do think over it cos there is a possiblity that you might be missing something. Wierd aint it.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| GoodGirl
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Topics: 92
Posts: 1,189
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new_n_lost wrote:
, I can only say onething that If in the real exam you find a question looking quite tough then you are only missing the point of the question and if you find a question easy then please do think over it cos there is a possiblity that you might be missing something. Wierd aint it.
I will keep it in my mind, thanks NNL, appreciate all the help you are providing us with.
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