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Discussion Starter · #1 ·
A 50 year old man brought to the ER because of unexplained loss of consciousness. The patient was found unconscious in a street near the hospital. His past medical and surgical history are unknown. His vitals were as follows;
Temp: 37C
BP: 110/70
Pulse: 120
RR: 25
Oxygen saturation was 84% on 100% Oxygen by mask.
Pupil reactive to light and equal. Patient responds only to painful stimuli. His lungs were full of crackles. His heart sounds were normal. All other systems were normal.
CBC, Chemistries, CXR, ECG were ordered.
The only available test results so far are the ABG which are:
PH 7.58, PCO2 22, PO2 49
What is the most likely diagnosis on the basis of this information?

A- Acute hyperventilation
B- Aspirin over dose
C- Pulmonary embolism
D- COPD with acute lung infection
E- Drug overdose
F- Sepsis
G- Renal failure
 

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I think this is a case of ARDS ... So, It could be due to sepsis, drug overdose, ...etc ...
But since its .... This is showing a respiratory alkalosis (Ph high, PCO2 low ... With a low PO2 or hypoxia with oxygen saturation 84% despite O2 suppliment) ... A probable case of Pulmonary embolism is the possible choice.
Choices like "COPD+Lung Infection" cause respiratory acidosis and hypoxia ...
 

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Discussion Starter · #4 ·
Yes, it's pulmonary embolism

yes, you are both right :)

Acute hyperventilation would also cause respiratory alkalosis but it should not show hypoxia

Aspirin over dose would show respiratory alkalosis but only to counteract the metabolic acidosis so the PH won't be that high.

Drug over dose and COPD cause respiratory acidosis not respiratory alkalosis

Renal failure and sepsis should cause metabolic acidosis
 
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