nb-Bl.3--3. Electrolyte? - usmle20

[ArchivalUser]

3. A 35-year-old man is brought to the emergency department because of intractable nausea and vomiting of nonbilious fluid over the past 48 hours. He has a history of duodenal ulcer disease treated with H2-receptor blocking agents. His temperature is 37 C (98.6 F), blood pressure is 90/60 mm Hg, pulse is 130/min, and respirations are 10/min. Examination shows mild epigastric tenderness. Which of the following are the most likely serum electrolyte findings?


Na+ Cl“ K+ HCO3“
(mEq/L) (mEq/L) (mEq/L) (mEq/L)

A
)
115 80 4.0 25

B
)
140 80 2.5 40

C
)
145 100 5.0 15

D
)
150 105 2.5 25

E
)
160 135 5.0 25

[ArchivalUser]

b.

[ArchivalUser]

B- loss of Cl and K tgrough vomiting--> dehydration--> increase Na

[ArchivalUser]

140 80 2.5 40

[ArchivalUser]

i think d
150 105 2.5 25
as the metabolic compensation 'll not take place,in met. alkalosis repiratory rate has already slowed down to retain the co2
usmle20 please reply

[ArchivalUser]

she is vomiting cl should be low

[ArchivalUser]

the patiets with vomiting present with hypochloremic,metabolic alkalosis,
Lose k ,b/a dehydration there is hypernatremia,so B

[ArchivalUser]

D. compensated metabolic alkalosis

[ArchivalUser]

A.
Patient is hypotensive:
Loss of Nacl, loss of Hcl and loss of K in the vomiting.

[ArchivalUser]

B.