Alice Dumont has come to her doctor not feeling well and the blood values show the following: pH 7.30 PCO2 40 mmHg HCO3 20 mEq/l

1. Is the pH high, low, or normal?

2. Is the patient showing acidosis, alkalosis, or neither?

3. Is the PCO2 high, low, or normal?

4. Is the respiratory system the cause of the condition, or is it compensating, or neither?

5. Is the HCO3 high, low, or normal?

6. Is the HCO3 the cause of the condition, or is it compensating, or neither?

7. Can you name the condition?

8. Can you give a possible cause?

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Keith LeannonLv2

27 Feb 2018

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A 23- year old male has been admitted for vomiting over the last2 days, with minimal fluid intake. He went to the emergency room ofa nearby hospital and the following data was obtained uponexamination and testing. Hematology: Hematocrit: 60% plasma pH:7.49 (normal is 7.35 to 7.45) pCO2: 47 mmHg (normal is 35 to 45mmHg) HCO3-: 31 (normal is 22 to 26 mEq/L) Urinalysis Appearance:dark yellow to brown Specific gravity: 1.025 (normal is 1.015 to1.030) Blood: negative Protein: mild pH 8.5

Questions: 1. Define acidosis and alkalosis. In general termshow can a patient develop an acidosis, an alkalosis?

2. What is the acid-base disorder this individual is sufferingfrom; explain your answer using the hematological data?

3. Has compensation occurred? If so, is it partial or complete,explain your answer?

4. Why does the patients have an alkaline urine?

burgundydinosaur227

1. MarthaÃ¢â¬â¢s first patient on the pediatric floor is a 12-year oldboy named Sam who is undergoing kidney dialysis treatment. Sam hasbeen on dialysis for the last week, and the treatments willprobably be discontinued because his kidneys are becoming fullyfunctional again. Martha questions SamÃ¢â¬â¢s mother concerning hisillness. Three weeks ago, Sam had a sore throat, which kept himhome from school for two days but was not medically treated. Oneweek ago, Sam told his mother his urine looked red-brown and foamy.He was admitted to the hospital. Physical exam revealedcostovertebral tenderness and blood pressure of 135/90. Theurinalysis and other studies revealed the following:

Color: red-brown tinged
Specific gravity: 1.030
RBCÃ¢â¬â¢s: numerous RBCÃ¢â¬â¢s per high powered field
Protein: > 1g/24 hr
Casts: epithelial cells and RBCÃ¢â¬â¢s
BUN: 90 mg/dl
Creatinine: 4mg/dl
Creatine Clearance Test: 50 ml/min

a. What is your diagnosis?
i. Glomerulonephritis
ii. Cystitis
iii. Urinary obstruction
iv. Pyelitis

b. The etiology would be a(n):
i. Virus
ii. Bacteria
iii. Genetic or developmental anomaly
iv. Anatomic malfunction after birth

2. Fred suffers from chronic emphysema. His arterial blood gasresults are as follows: pH 7.30; bicarbonate 32 mEq/l; PCO2 50 mmHg. Which of the following best describe FredÃ¢â¬â¢s condition?
a. Metabolic acidosis with respiratory compensation
b. Respiratory acidosis with metabolic compensation
c. Metabolic alkalosis with respiratory compensation
d. Respiratory alkalosis with metabolic compensation

3. Hypocalcaemia may develop in a patient with which of thefollowing conditions?
a. Chronic renal failure
b. Hyperparathyroidism
c. Thiazide therapy
d. Vitamin D overdose

4. Which of the following conditions would cause prerenalfailure?
a. Nephrotoxicity
b. Glomerulonephritis
c. Acute tubular necrosis
d. Hypovolemia

5. Abnormal serum laboratory findings common to patients with acuterenal failure are:
a. Increased potassium and BUN; decreased creatinine
b. Increased potassium and creatinine; decreased BUN
c. Decreased potassium; increased BUN and creatinine
d. Increased potassium, BUN and creatinine

6. In the diuretic phase of acute tubular necrosis (ATN), theclinician must be alert for which of the followingcomplications?
a. Fluid overload
b. Hypokalemia
c. Hypertension
d. Hypernatremia

7. The primary acid-base disorder associated with renal failureis:
a. Respiratory acidosis
b. Metabolic acidosis
c. Respiratory alkalosis
d. Metabolic alkalosis

8. Patients with acute renal failure may have all of the followingcomplications EXCEPT:
a. Peaked T wave EKG and pericarditis
b. Sinus tachycardia and ST elevation
c. Heart failure and Friction rub
d. Mitral insufficiency and Mobitz type II heart block

9. A patientÃ¢â¬â¢s glomerular filtration rate can be measure byevaluating:
a. Serum creatinine
b. Blood urea nitrogen
c. Serum osmolarity
d. Creatinine clearance

10. A patient taking medication that acts to block or inhibit theaction of aldosterone would:
a. Have high blood potassium levels
b. Have high blood sodium levels
c. Have high levels of circulating aldosterone
d. A, B, and C
e. A and C only

11. A patient exhibits the following signs and symptoms: Elevatedblood pressure, elevated blood glucose, muscle weakness, poor woundhealing, red cheeks, thin arms and legs with fat deposits in thetrunk, neck and face. The patient findings are consistentwith:
a. AddisonÃ¢â¬â¢s Disease
b. Myxedema
c. CushingÃ¢â¬â¢s disease or long-term high dose steroid use
d. GraveÃ¢â¬â¢s disease
e. Pheochoromocytoma

12. The MOST dramatic functional change that occurs in theendocrine system due to aging is
a. A decrease in blood and tissue concentrations of ADH andTSH
b. And overall decrease in circulating levels of mosthormones.
c. A decline in the concentration of reproductive hormones
d. And increase in the secretion of glucocortioids

magentaswan670

1. MarthaÃ¢â¬â¢s first patienton the pediatric floor is a 12-year old boy named Sam who isundergoing kidney dialysis treatment. Sam has been on dialysis forthe last week, and the treatments will probably be discontinuedbecause his kidneys are becoming fully functional again. Marthaquestions SamÃ¢â¬â¢s mother concerning his illness. Three weeks ago,Sam had a sore throat, which kept him home from school for two daysbut was not medically treated. One week ago, Sam told his motherhis urine looked red-brown and foamy. He was admitted to thehospital. Physical exam revealed costovertebral tenderness andblood pressure of 135/90. The urinalysis and other studies revealedthe following:

Color: red-brown tinged
Specific gravity: 1.030
RBCÃ¢â¬â¢s: numerous RBCÃ¢â¬â¢s per high poweredfield
Protein: > 1g/24 hr
Casts: epithelial cells and RBCÃ¢â¬â¢s
BUN: 90 mg/dl
Creatinine: 4mg/dl
Creatine Clearance Test: 50 ml/min

a. What is yourdiagnosis?
i. Glomerulonephritis
ii. Cystitis
iii. Urinary obstruction
iv. Pyelitis

b. The etiology would bea(n):
i. Virus
ii. Bacteria
iii. Genetic or developmental anomaly
iv. Anatomic malfunction after birth

2. Fred suffers from chronic emphysema.His arterial blood gas results are as follows: pH 7.30; bicarbonate32 mEq/l; PCO2 50 mm Hg. Which of the following best describeFredÃ¢â¬â¢s condition?
a. Metabolic acidosis with respiratorycompensation
b. Respiratory acidosis with metaboliccompensation
c. Metabolic alkalosis with respiratorycompensation
d. Respiratory alkalosis with metaboliccompensation

3. Hypocalcaemia may develop in a patientwith which of the following conditions?
a. Chronic renal failure
b. Hyperparathyroidism
c. Thiazide therapy
d. Vitamin D overdose

4. Which of the following conditions wouldcause prerenal failure?
a. Nephrotoxicity
b. Glomerulonephritis
c. Acute tubular necrosis
d. Hypovolemia

5. Abnormal serum laboratory findingscommon to patients with acute renal failureare:
a. Increased potassium and BUN; decreasedcreatinine
b. Increased potassium and creatinine; decreasedBUN
c. Decreased potassium; increased BUN andcreatinine
d. Increased potassium, BUN andcreatinine

6. In the diuretic phase of acute tubularnecrosis (ATN), the clinician must be alert for which ofthe following complications?
a. Fluid overload
b. Hypokalemia
c. Hypertension
d. Hypernatremia

7. The primary acid-base disorderassociated with renal failure is:
a. Respiratory acidosis
b. Metabolic acidosis
c. Respiratory alkalosis
d. Metabolic alkalosis

8. Patients with acute renal failure mayhave all of the following complicationsEXCEPT:
a. Peaked T wave EKG and pericarditis
b. Sinus tachycardia and ST elevation
c. Heart failure and Friction rub
d. Mitral insufficiency and Mobitz type II heartblock

9. A patientÃ¢â¬â¢s glomerular filtrationrate can be measure by evaluating:
a. Serum creatinine
b. Blood urea nitrogen
c. Serum osmolarity
d. Creatinine clearance

10. A patient taking medication that actsto block or inhibit the action of aldosteronewould:
a. Have high blood potassium levels
b. Have high blood sodium levels
c. Have high levels of circulatingaldosterone
d. A, B, and C
e. A and C only

11. A patient exhibits the following signsand symptoms: Elevated blood pressure, elevated blood glucose,muscle weakness, poor wound healing, red cheeks, thin arms and legswith fat deposits in the trunk, neck and face. The patient findingsare consistent with:
a. AddisonÃ¢â¬â¢s Disease
b. Myxedema
c. CushingÃ¢â¬â¢s disease or long-term high dosesteroid use
d. GraveÃ¢â¬â¢s disease
e. Pheochoromocytoma

12. The MOST dramatic functional changethat occurs in the endocrine system due to agingis
a. A decrease in blood and tissue concentrationsof ADH and TSH
b. And overall decrease in circulating levels ofmost hormones.
c. A decline in the concentration of reproductivehormones
d. And increase in the secretion ofglucocortioids