A 34-year-old woman presents with 2 days of profuse diarrhea after returning from a camping trip. Vital signs show BP 98/62 mm Hg, HR 108 bpm, RR 22/min, temperature 37.2°C, and SpO2 98% on room air. She appears dehydrated with dry mucous membranes. Arterial blood gas reveals pH 7.28, PaCO2 30 mm Hg, HCO3− 14 mEq/L, and serum electrolytes show normal anion gap. She denies vomiting. Which of the following best describes her respiratory status?

  1. A)Primary respiratory alkalosis with renal compensation
  2. B)Superimposed respiratory alkalosis
  3. C)Mixed metabolic alkalosis and respiratory acidosis
  4. D)Appropriate respiratory compensationGABARITO
  5. E)Superimposed respiratory acidosis

Explicação

For metabolic acidosis, expected PaCO2 by Winter formula is 1.5 x HCO3− + 8 ± 2, which here is 1.5 x 14 + 8 = 29 ± 2 mm Hg. The measured PaCO2 of 30 mm Hg is appropriate compensation, consistent with primary metabolic acidosis from bicarbonate loss in diarrhea... Ver explicação completa e trilha adaptativa →

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