[MedicalExams]

1) A 36 year old woman presents to her primary care doctor for medical clearance. She is planning on a elective hernial repair. She was recently diagnosed with sarcoidosis several months ago and placed on prednisone. Upon inspection, her physician notices a well nourished woman with telangiectasias and purple red marks on her extremeties. She also has some signs of hirsutism that he did not notice on her previous visit several months ago.


Which of the following would correctly describe her primary acid-base disturbance?

A) Low pH, Low HCO3, High Base Deficit, Low pCO2.
B) Low pH, High HCO3, High Base Excess, High pCO2.
C) Neutal pH, Low HCO3, High Base Deficit, Low pCO2.
D) High pH, High HCO3, High Base Excess, High pCO2.
E) High pH, Low HCO3, High Base Excess, Low pCO2.

Explanation will be posted soon....

 

[khanar]

Reasoning

the woman developed iatrogenic cushing syndrome
therefore she's obese
therefore she's have pickwickian syndrome
therefore she'll have respiratory acidosis
therefore Choice B is the correct answer

 

[drmodi44]

ya its a cushing syndrome...but exogenous steroids have weak mineralocorticoid action....which can lead to metabolic alkalosis....so it should be
D) High pH, High HCO3, High Base Excess, High pCO2.

high pCO2 may be due to respiratory compensation....

 

[MedicalExams]

ya its a cushing syndrome...but exogenous steroids have weak mineralocorticoid action....which can lead to metabolic alkalosis....so it should be
D) High pH, High HCO3, High Base Excess, High pCO2.

high pCO2 may be due to respiratory compensation....

Great discussion!

 

[khanar]

Disagree

ya its a cushing syndrome...but exogenous steroids have weak mineralocorticoid action....which can lead to metabolic alkalosis....so it should be
D) High pH, High HCO3, High Base Excess, High pCO2.

high pCO2 may be due to respiratory compensation....

I don't think we should be thinking in that direction. They should have put some other hints if it was hyperaldosteronims, such as high Na and low K. Since they didn't not mention that then I think it's Pickwickian syndrome.

Hey MedicalExams,
When are you going to put the answer :toosad:

 

[MedicalExams]

I don't think we should be thinking in that direction. They should have put some other hints if it was hyperaldosteronims, such as high Na and low K. Since they didn't not mention that then I think it's Pickwickian syndrome.

Hey MedicalExams,
When are you going to put the answer :toosad:

After more users get involved in the discussion and more answers are posted.

If want the explanations right away you can sign up for a FREE account on MedicalExams.com and try these exact questions with the full explanations.

Why not try it out Chessmatic?

 

[MedicalExams]

I don't think we should be thinking in that direction. They should have put some other hints if it was hyperaldosteronims, such as high Na and low K. Since they didn't not mention that then I think it's Pickwickian syndrome.

Hey MedicalExams,
When are you going to put the answer :toosad:

You can also join us on FACEBOOK We have questions with answers in our "Discussions" tab.

Cheers,

MedicalExams Team

 

[khanar]

Nice

You can also join us on FACEBOOK We have questions with answers in our "Discussions" tab.

Cheers,

MedicalExams Team

Oh yes, I will sure do

 

[MedicalExams]

Oh yes, I will sure do

Sounds good.