Question

A patient is admitted to the hospital in complete collapse. His blood pH is 6.8, and his HCO3- is 20 mEq/L. A medical history reveals that this patient is a chronic alcoholic. What diagnosis would you give, and what prognosis?

1) The pH and bicarbonate levels and the history of alcoholism indicate metabolic alkalosis. The patient will require dialysis to remove the bicarbonate ions.
2) The pH and bicarbonate levels and the history of alcoholism indicate respiratory acidosis. The patient will require dialysis to remove the bicarbonate ions.
3) The pH and bicarbonate levels and the history of alcoholism indicate respiratory acidosis. The patient will go into a coma and death soon follows.
4) The pH and bicarbonate levels and the history of alcoholism indicate respiratory alkalosis. The patient will require dialysis to remove the bicarbonate ions.
5) The pH and bicarbonate levels and the history of alcoholism indicate metabolic acidosis. The patient will go into a coma and death soon follows.

Answer 1

The patient is experiencing metabolic acidosis due to very low blood pH and bicarbonate levels, compounded by their history of alcoholism. Urgent medical intervention is required to correct the acid-base imbalance and prevent severe complications.

Step-by-step explanation:

The patient with a blood pH of 6.8 and an HCO3- level of 20 mEq/L, along with a history of chronic alcoholism, would be diagnosed with metabolic acidosis. This is because the pH is well below the normal range, indicating an acidic environment, and the bicarbonate level is low but not excessively low, suggesting primary bicarbonate deficiency. Chronic alcoholism can lead to the accumulation of organic acids in the blood, contributing to metabolic acidosis. The prognosis can vary based on the patient's overall health and responsiveness to treatment, but without intervention, severe metabolic acidosis can lead to coma and possibly death. Correction of the acid-base imbalance is urgent and typically involves administration of intravenous bicarbonate, among other treatments, not dialysis in this context.