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  #1  
Old 01-05-2012
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Question ABG Question

A 30-year-old obese female bus driver develops sudden pleuritic leftsided chest pain and dyspnea. For the clinical situation, select the arterial blood gas and pH values with which it is most likely to be associated ?


A. pH 7.50, PO2 75, PCO2 28
B. pH 7.15, PO2 78, PCO2 92
C. pH 7.06, PO2 36, PCO2 95
D. pH 7.06, PO2 108, PCO2 13
E. pH 7.39, PO2 48, PCO2 54
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  #2  
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go with A..

obese so hypercog ...pul embo...
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  #3  
Old 01-05-2012
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E.........
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E may be
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Quote:
Originally Posted by scopusmount View Post
A 30-year-old obese female bus driver develops sudden pleuritic leftsided chest pain and dyspnea. For the clinical situation, select the arterial blood gas and pH values with which it is most likely to be associated ?


A. pH 7.50, PO2 75, PCO2 28
B. pH 7.15, PO2 78, PCO2 92
C. pH 7.06, PO2 36, PCO2 95
D. pH 7.06, PO2 108, PCO2 13
E. pH 7.39, PO2 48, PCO2 54
..............................
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  #6  
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She being a bus driver yeah A is the ans
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Old 01-06-2012
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Quote:
Originally Posted by indigo View Post
She being a bus driver yeah A is the ans
can u xpplain role as bus driver in tis q?
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  #8  
Old 01-06-2012
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sedentary life style,venous stasis
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  #9  
Old 01-06-2012
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Ans A

bus driver-DVT -thromboembolism to lung-pulmonary embolism -hyperventilation - high pH, low PCO2, low PO2
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  #10  
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you have pleuritic chest pain so hyperventilation should be fast and shallow leading to acidosis!
to confirm that, we hv an inc'd dead space which means you have ventilation but no perfusion, which means your alveolar content in that part will be just the same as inspired air....which inc's PaCO2 and dec's PaO2

but by what degree cuz both B and C are likely choices

I'd pick B
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C. pH 7.06, PO2 36, PCO2 95
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A seems the answer
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Old 01-07-2012
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A) CORRECT, The blood gas values associated with pulmonary embolism may vary tremendously. The most consistent finding is acute respiratory alkalosis. It is important to note that hypoxemia, although frequently found, need not be present. In severe chronic lung disease, the presence of hypercapnia leads to a compensatory increase in serum bicarbonate. Thus, significant hypercapnia may be present with an arterial pH close to normal, but will never be completely corrected. Acute respiratory acidosis may occur secondary to respiratory depression after drug overdose. Hypoventilation is associated with hypoxia; hypercapnia; and severe, uncompensated acidosis. In the presence of long-standing lung disease, respiration may become regulated by hypoxia rather than by altered carbon dioxide tension and arterial pH, as in normal people. Thus, the unmonitored administration of oxygen may lead to respiratory suppression, that results in acute and chronic respiratory acidosis. Young patients with type 1 diabetes mellitus may present with rapid onset of diabetic ketoacidosis (DKA), usually secondary to a systemic infection. These patients usually are maximally ventilating, as indicated by a very low arterial PCO2; however, they remain acidotic secondary to the severe metabolic ketoacidosis associated with this process. In general, these patients are not hypoxic unless the underlying infection is pneumonia.
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