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Acid Base puzzle..need help!!! - bep111
#1
A 41 yrs old women with shortness of breath 7 hemoptysis, complaining of chest pain was noted to have unilateral leg swelling 4-6 monthes after a right upper lobectomy for carcinoma lung...his AB status presently can be indicated by:

a.Metabolic Acidosis;
b.metabolic alkalosis;
c.RespiratoryAcidosis;
d.respiratory alkalosis;
e.normal pH.
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#2
c.RespiratoryAcidosis?
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#3
lobectomy can lead to dec. in v/q ratio leading to retention of co2 in blood causing low ph and acidosis. but i m also not sure abt the explanation. Smile
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#4
i was thinking along the lines of possible pulmonary emboli and infract... but i think that would also give answer c) respiratory acidosis.
basically, as uk_doc wrote... the patient has retention of co2 ... i would go with acidosis. and respiratory since it's a lung problem.
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#5
d.Respiratory Alkalosis( +Metabolic acidosis compensatory or if accompanying cardiac attest present);

Sorry guys this ans has given here...

Explaination:
Dx: Pulmonary embolism(clue: dyponoea).
pt will be hyperventilation......so Respiratory Alkalosis( Co2 removal in excess).

Following lobectomy Blood gas analysis should not altered grossly.....
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#6
good
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#7
uk_doc thanks for.....sharing the problem solution!!!
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#8
u r going great bep111. great inspiration for me.
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#9
I wish other progressive/confident members (of this forum) ....are as supporting as you !!
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#10
good problem/question. i thought shortness of breath would mean she wasn't ventilating well. thanks for straightening it out for me before the real exam.
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