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  #1  
Old 12-20-2011
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Question Woman with bronchitis and compensated acid base status

A 75-year-old woman with chronic bronchitis comes to the physician for a follow-up examination. The following data are obtained from an arterial blood sample:
pH: 7.39
Pco2 55 mm Hg
Plasma bicarbonate concentration 32 mEq/L

Which of the following is the major compensatory response to this patient’s acid-base disorder?
[A] Decreased renal bicarbonate ion excretion
[B] Hyperventilation
[C] Hypoventilation
[D] Increased excretion of free H+
[E] Increased renal ammonium ion secretion
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I think its A
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i think its D
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I think its A
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I'll go wid D...
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Old 12-20-2011
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is tis q rt? ph is 7.39 which is normal!!!

if still tis is q...ill go wit A as its bronchitis likely 2 retain co2
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Old 12-20-2011
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Correct answer is E according to kaplan.

My explanation is bronchitis it, causes acidosis and the Ph is normal cos of renal compensation,which can be either loss of acid or retaining bicarb,but the major mechanism will be excreting acid which will bind to ammonia forming ammonium,as there is a limit to the free H+ that can be excreted in the urine.

Pls correct me if I am wrong
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Old 12-20-2011
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Quote:
Originally Posted by indigo View Post
Correct answer is E according to kaplan.

My explanation is bronchitis it, causes acidosis and the Ph is normal cos of renal compensation,which can be either loss of acid or retaining bicarb,but the major mechanism will be excreting acid which will bind to ammonia forming ammonium,as there is a limit to the free H+ that can be excreted in the urine.

Pls correct me if I am wrong
Yes major mechanism of H+ excretion is by buffering it with ammonium buffer or phosphate buffer.

Nice question indigo. BTW is this question of Kaplan notes or Qbank/book?
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Old 12-20-2011
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i thought E is use to secret fixed acid like in ketoacidosis and here there is no fixed acid??
please more explanation
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