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A 3 year old is brought to the pedes ER at ~3am, stuporous and tachypneic. History is remarkable for his parents having cleaned out their medicine cabinet earlier that day. An ABG and electrolytes have been accidentally drawn by the nurse.
Available data: pH=7.53, PaCO2=12; Na+=140, K+=3.0, Cl-=106, HCO3=10
What is the primary disturbance
What is the anion gap
is mixed disorder present?if present then what is the final diagnosis?
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looks like resp. alkalosis due to dec pCO2(hyperventilation)...the dec in HCO3 is the metabollic compensation for it.....
the anion gap is=143-116=27
i don't think there is a mixed disorder cuz the values of PCO2 & HCO3 are decreasing in the same direction....
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increased anion gap ie 24 with metabolic disorder
superimposed metabolic acidosis
combined respiratory alkalosis with metabolic acidosis..seen in salicylate poisioning and sepsis
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I agree with lucky-this is a mixed acid-base disorder of resp alkalosis-met acidosis due to salicylate poisoning. Typical presentation in children.Anion gap is 27 but the decreased bicarb {10} cant be a compensatory response as remember, compensation is never complete.
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ya
the answer is respiratory alkalosis with metabolic acidosis
wide anion gap type of metabolc acidosis
seen in salicylate poisoing and sepsis
with primary disorder is respiratory alkslosis.
