A 38-year-old woman presents with acute dyspnea and pleuritic chest pain after a 12-hour international flight. Vital signs: BP 128/82, HR 102, RR 22, SpO2 91% on room air, temperature 37.2°C. Arterial blood gas shows pH 7.48, PaCO2 30 mmHg, PaO2 72 mmHg, HCO3 22 mEq/L. Chest X-ray is normal. She denies leg swelling. Which acid-base disturbance is present, and what condition does it suggest?
- A)Acute respiratory alkalosis, consistent with pulmonary embolismGABARITO
- B)Chronic respiratory alkalosis, consistent with high-altitude exposure
- C)Acute respiratory acidosis, consistent with COPD exacerbation
- D)Mixed metabolic alkalosis and respiratory acidosis, consistent with vomiting with COPD
- E)Metabolic acidosis, consistent with sepsis
Explicação
The ABG shows a low PaCO2 (30 mmHg) with a high pH (7.48) and normal bicarbonate (22 mEq/L), indicating acute respiratory alkalosis. This pattern is classic for PE: tachypnea driven by hypoxemia and dead space ventilation causes CO2 washout. The history of pro... Ver explicação completa e trilha adaptativa →