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A 50-year-old male presents in the emergency department (ED) complaining of frequent vomiting. Arterial blood gas results on room air show:

pH 7.54 PaCO2 41 torr
PaO2 96 torr
HCO3- 30 mEq/L
BE +6 mEq/L
Which of the following would account for this blood gas anomaly?
A. K+ 3.4 mEq/L
B. Cl- 110 mEq/L
C. K+ 4.9 mEq/L
D. Hyperventilation

User Bbrumm
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1 Answer

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Final answer:

The blood gas anomaly with a pH of 7.54 and elevated HCO3- suggests metabolic alkalosis, and the high Cl- level of 110 mEq/L (Option B) could account for this condition, as it indicates a loss of acid and a positive base balance. The correct option is (B)

Step-by-step explanation:

The patient's arterial blood gas results show a pH of 7.54, which indicates alkalosis. Given a PaCO2 of 41 torr (which is within normal limits) and an elevated HCO3- of 30 mEq/L and BE (Base Excess) of +6 mEq/L, the patient is likely experiencing metabolic alkalosis. The listed options aim to identify an associated abnormality that could account for this blood gas abnormality.

Option A shows a potassium level of 3.4 mEq/L, which is slightly lower than normal but does not directly explain the alkalosis. Option B lists a chloride (Cl-) level of 110 mEq/L, which is high and could suggest the presence of metabolic alkalosis due to chloride's role in maintaining acid-base balance. Option C presents a normal potassium level of 4.9 mEq/L, unrelated to the alkalosis. Option D, hyperventilation, is incorrect as it would lead to a low PaCO2 and respiratory alkalosis, not metabolic. Therefore, Option B, with a Cl- of 110 mEq/L, would be the likely explanation as it indicates a loss of acid (via chloride) leading to metabolic alkalosis, which aligns with the increased level of bicarbonate in the blood.

User Branden Ghena
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