05-13-2007, 04:33 PM
A 53-year-old, male, comes in complaining of intractable vomiting. He states that he as had peptic ulcer disease for years, and is currently taking an H2 blocking agent. He has also been taking over-the-counter antacids, frequently. He admits a feeling of fullness and early satiety for the past week. He adds that began vomiting yesterday morning, and now he can't keep anything down. In addition to these concerns, the patient complains of tingling in his arms to the elbow with some cramping. Physical exam reveals an ill appearing male.
Vital signs are: Temp 37.8° C (100.04° F); pulse 105; BP 110/70; respiration 10, and shallow.
Initial studies show a CBC: WBC: 13.5; H/H 14/42; Chem 7: Na 132; K 3.1; Cl 85; HCO3 35.
Obstruction series shows a massively dilated stomach with minimal distal gas noted.
UA shows SG 1.025, no cells, urine chloride is 8mEq/L.
Which of the following best describes this patient's acid base disorder?
|||||||||
A
Saline-responsive metabolic alkalosis
|||||||||
B
Saline-resistant metabolic alkalosis
|||||||||
C
Distal renal tubular alkalosis
|||||||||
D
Milk alkali syndrome
|||||||||
E
Acute licorice ingestion
Vital signs are: Temp 37.8° C (100.04° F); pulse 105; BP 110/70; respiration 10, and shallow.
Initial studies show a CBC: WBC: 13.5; H/H 14/42; Chem 7: Na 132; K 3.1; Cl 85; HCO3 35.
Obstruction series shows a massively dilated stomach with minimal distal gas noted.
UA shows SG 1.025, no cells, urine chloride is 8mEq/L.
Which of the following best describes this patient's acid base disorder?
|||||||||
A
Saline-responsive metabolic alkalosis
|||||||||
B
Saline-resistant metabolic alkalosis
|||||||||
C
Distal renal tubular alkalosis
|||||||||
D
Milk alkali syndrome
|||||||||
E
Acute licorice ingestion