30 Acid Base Questions

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#1. A 60-year-old man with a history of chronic obstructive pulmonary disease (COPD) is admitted to the hospital with worsening shortness of breath. Arterial blood gas (ABG) analysis reveals a pH of 7.25, pCO2 of 60 mmHg, and bicarbonate (HCO3-) of 25 mEq/L. Which of the following is the most likely diagnosis?

#2. A 56-year-old man presents to the emergency department with shortness of breath, confusion, and lethargy. His medical history includes hypertension and chronic obstructive pulmonary disease (COPD). His vital signs are as follows: temperature 37.0°C (98.6°F), blood pressure 160/100 mmHg, heart rate 110 beats/min, respiratory rate 28 breaths/min, and oxygen saturation 90% on room air. On physical examination, he appears drowsy, and his lungs are clear to auscultation. Arterial blood gas (ABG) analysis reveals pH 7.27, pCO2 60 mmHg, and HCO3- 27 mEq/L. Which of the following is the most likely acid-base disorder?

#3. A 25-year-old man with a history of alcohol abuse is admitted to the hospital with severe dehydration and electrolyte imbalance. His laboratory results show a serum pH of 7.25, PCO2 of 30 mmHg, and bicarbonate (HCO3-) of 14 mEq/L. Which of the following is the most likely cause of his acid-base disorder?

#4. A 50-year-old male with a history of chronic obstructive pulmonary disease (COPD) presents to the emergency department with shortness of breath and a pH of 7.25. Arterial blood gas analysis shows a pCO2 of 70 mmHg and a bicarbonate level of 26 mEq/L. Which of the following is the most likely acid-base disturbance?

#5. A 32-year-old woman is admitted to the emergency department with a one-day history of vomiting and diarrhea. She is tachypneic and has a respiratory rate of 28 breaths per minute. Arterial blood gas analysis reveals a pH of 7.32, a PaCO2 of 27 mmHg, and a bicarbonate concentration of 14 mEq/L. Which of the following is the most likely diagnosis?

#6. A 35-year-old male patient is brought to the emergency department with severe abdominal pain, nausea, and vomiting. On examination, his respiratory rate is 30 breaths per minute, blood pressure is 110/70 mmHg, and heart rate is 120 beats per minute. Arterial blood gas analysis reveals a pH of 7.2, PaCO2 of 20 mmHg, and bicarbonate concentration of 8 mEq/L. Which of the following acid-base disturbances is most likely present in this patient?

#7. A 65-year-old woman with a history of chronic obstructive pulmonary disease (COPD) and a 20-pack-year history of smoking presents to the emergency department with shortness of breath and confusion. Arterial blood gas analysis reveals a pH of 7.25, a pCO2 of 70 mmHg, and a HCO3- of 28 mEq/L. Which of the following is the most likely diagnosis?

#8. A 54-year-old male with a history of chronic obstructive pulmonary disease (COPD) presents to the emergency department with increasing shortness of breath, cough and sputum production. His vital signs are as follows: blood pressure 145/90 mmHg, heart rate 100 beats per minute, respiratory rate 28 breaths per minute, and oxygen saturation 89% on room air. Arterial blood gas analysis reveals the following: pH 7.25, pCO2 70 mmHg, bicarbonate (HCO3-) 30 mEq/L. Which of the following is the most likely cause of this patient's acid-base abnormality?

#9. Question: A 28-year-old male presents to the emergency department with vomiting and diarrhea for the past 2 days. On examination, he is tachycardic and hypotensive with dry mucous membranes. His laboratory values are as follows: pH 7.20, PaCO2 35 mmHg, HCO3- 15 mEq/L. Which of the following is the most likely acid-base disturbance in this patient?

#10. A 45-year-old man presents to the emergency department with shortness of breath, cough, and confusion. He has a history of chronic obstructive pulmonary disease (COPD) and is currently taking albuterol and ipratropium nebulizers. His arterial blood gas (ABG) results are as follows: pH 7.25, PaCO2 60 mmHg, HCO3- 25 mEq/L. Which of the following is the most likely diagnosis?

#11. A 45-year-old male presents to the emergency department with shortness of breath, confusion, and dizziness. His blood gas analysis shows a pH of 7.20, PCO2 of 50 mmHg, and HCO3- of 25 mEq/L. Which of the following is the most likely diagnosis?

#12. A 45-year-old woman with a history of chronic obstructive pulmonary disease (COPD) presents to the emergency department with worsening shortness of breath and confusion. Her arterial blood gas (ABG) results are as follows: pH 7.20, PaCO2 80 mmHg, PaO2 70 mmHg, and bicarbonate (HCO3-) 24 mEq/L. Which of the following acid-base disturbances is present in this patient?

#13. A 45-year-old male patient is admitted to the hospital with acute pancreatitis. Arterial blood gas analysis reveals a pH of 7.33, a PaCO2 of 40 mmHg, and a HCO3- level of 20 mEq/L. Which of the following is the most likely cause of the patient's acid-base disturbance?

#14. A 60-year-old man with a history of chronic obstructive pulmonary disease (COPD) is brought to the emergency department with shortness of breath and confusion. The arterial blood gas analysis shows pH 7.25, PaCO2 70 mm Hg, and HCO3- 30 mEq/L. Which of the following is the most likely acid-base disturbance?

#15. A 35-year-old male presents to the emergency department with complaints of shortness of breath and confusion. His medical history is significant for chronic obstructive pulmonary disease (COPD). On physical examination, he is tachycardic and tachypneic, and his blood pressure is 160/90 mmHg. Laboratory studies reveal a pH of 7.25, pCO2 of 70 mmHg, and HCO3- of 30 mEq/L. Which of the following is the most likely acid-base disturbance in this patient?

#16. A 32-year-old male presents to the emergency department with shortness of breath, chest pain, and confusion. His vital signs are as follows: temperature 37°C (98.6°F), heart rate 118 bpm, respiratory rate 28 breaths/min, blood pressure 160/100 mmHg, and oxygen saturation 89% on room air. Arterial blood gas analysis reveals a pH of 7.20, pCO2 of 60 mmHg, and bicarbonate concentration of 24 mEq/L. Which of the following is the most likely cause of the patient's acid-base imbalance?

#17. A 35-year-old male with a history of chronic alcohol abuse is brought to the emergency department with acute respiratory distress. He is hyperventilating and has a respiratory rate of 30 breaths per minute. Arterial blood gas analysis reveals pH of 7.50, PCO2 of 25 mmHg, and bicarbonate of 20 mEq/L. Which of the following is the most likely diagnosis?

#18. A 55-year-old female presents with a history of vomiting, diarrhea, and confusion. Her blood pressure is 90/60 mm Hg, heart rate is 110 bpm, and respiratory rate is 20 breaths per minute. Laboratory studies show a pH of 7.25, pCO2 of 18 mm Hg, and bicarbonate level of 12 mEq/L. Which of the following is the most likely diagnosis?

#19. A 35-year-old male presents to the emergency department with confusion and lethargy. The patient reports a history of alcohol abuse and has not been taking his medications as prescribed. On physical examination, the patient is found to be hypotensive with a heart rate of 120 bpm. Laboratory studies reveal a serum sodium of 130 mEq/L, serum potassium of 2.8 mEq/L, serum chloride of 96 mEq/L, bicarbonate of 10 mEq/L, and pH of 7.20. What is the most likely diagnosis?

#20. A 42-year-old man is admitted to the emergency department with confusion, lethargy, and shortness of breath. His arterial blood gas analysis shows a pH of 7.24, PCO2 of 55 mmHg, HCO3- of 23 mEq/L, and a calculated anion gap of 15. What is the most likely diagnosis?

#21. A 32-year-old man presents to the emergency department with vomiting and diarrhea for the past 2 days. His laboratory results show a pH of 7.25, a PCO2 of 20 mmHg, and a HCO3- of 10 mEq/L. Which of the following acid-base disturbances is present in this patient?

#22. A 55-year-old male with a history of chronic obstructive pulmonary disease (COPD) presents to the emergency department with shortness of breath, tachypnea, and confusion. Arterial blood gas analysis reveals a pH of 7.25, PaCO2 of 70 mmHg, and HCO3- of 28 mEq/L. Which of the following is the most likely acid-base disorder?

#23. A 30-year-old female with a history of anorexia nervosa presents to the emergency department with complaints of abdominal pain, vomiting, and confusion. Her vital signs include a blood pressure of 90/60 mmHg, a heart rate of 110 beats per minute, and a respiratory rate of 28 breaths per minute. Blood tests reveal a pH of 7.25, pCO2 of 30 mmHg, and bicarbonate (HCO3-) of 16 mEq/L. Which of the following is the most likely cause of the patient's acid-base disturbance?

#24. A 35-year-old male presents to the emergency department with complaints of nausea, vomiting, and abdominal pain for the past day. On physical examination, the patient is tachycardic and tachypneic. Arterial blood gas analysis shows a pH of 7.25, a pCO2 of 30 mmHg, and a bicarbonate level of 16 mEq/L. Which of the following is the most likely cause of the patient's acid-base disturbance?

#25. A 55-year-old male with a history of chronic obstructive pulmonary disease (COPD) presents to the emergency department with shortness of breath, tachypnea, and confusion. Arterial blood gas analysis reveals a pH of 7.25, PaCO2 of 70 mmHg, and HCO3- of 28 mEq/L. Which of the following is the most likely acid-base disorder?

#26. A 56-year-old woman with a history of chronic obstructive pulmonary disease (COPD) presents to the emergency department with dyspnea and confusion. Arterial blood gas results show a pH of 7.25, pCO2 of 70 mmHg, and HCO3- of 30 mEq/L. Which of the following is the most likely acid-base disturbance present in this patient?

#27. A 25-year-old female presents to the emergency department with shortness of breath, fatigue, and confusion. Arterial blood gas analysis shows a pH of 7.20, pCO2 of 35 mmHg, and bicarbonate (HCO3-) of 15 mEq/L. Which of the following is the most likely cause of her acid-base disturbance?

#28. A 45-year-old male patient is admitted to the hospital with severe vomiting and diarrhea. The patient reports feeling weak and dizzy. The nurse assesses the patient and finds a blood pressure of 90/60 mmHg, pulse rate of 120 beats per minute, respiratory rate of 20 breaths per minute, and a temperature of 101.5°F. Arterial blood gas analysis reveals a pH of 7.25, pCO2 of 35 mmHg, and HCO3- of 14 mEq/L. Which of the following acid-base disturbances is most likely present in this patient?

#29. A 45-year-old male patient presents to the emergency department with complaints of severe abdominal pain, vomiting, and diarrhea. The patient is noted to have a pH of 7.32, pCO2 of 30 mmHg, HCO3- of 14 mEq/L, and anion gap of 20 mEq/L. Which of the following acid-base disorders is most likely present in this patient?

#30. A 55-year-old man with chronic obstructive pulmonary disease (COPD) presents to the emergency department with worsening shortness of breath. Arterial blood gas analysis shows pH 7.32, pCO2 70 mmHg, and bicarbonate (HCO3-) 35 mEq/L. Which of the following is the most likely cause of this acid-base disturbance?

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