Question

A patient has mild metabolic acidosis from a not-too-severe diabetic decompensation leading to keno-acidosis. The patient's pH is 7.49 with a bicarbonate =16.>. What is the most likely explanation for these data?

a) this is compatible with a single acid-base

b) solely from this data, you can determine that there is a simultaneous metabolic alkalosis

c) these numbers can be explained by a simultaneous respiratory alkalosis

d) the patient's respirations are probably about 7 per minute and shallow, with the smell of acetone

Answer 1

Option C-these numbers can be explained by a simultaneous respiratory alkalosis

The normal blood pH of blood is regulated between 7.35 and 7.45.

normal range of Bicarbonates 22 to 29 mEq/L

Acidosis occur when Ph is less than 7.35 and abnormal serum bicarbonate concentration below 22 mEq/L.

But when an Acidosis occur body tries to Compensate the acidosis by -

1.Altering renal excretion of H+.

2. Increases the respiratory rate (Hyper ventillation)to remove CO2 .

As a Result there will be Respiratory Alkalosis - pH may be high or near normal and Bicarbonate level will be Low.

In metabolic Alkalosis-Ph will be greater than 7.45 also Bicarbonate concentration will be Increased.So here Since Bicarbonate level is less,it is not metabolic alkalosis.

Also In respiratory Compensation There hyperventillation or Deep Rapid Breathing so Respiratory Rate will be high.