Acid Base Assignment

Acid Base Assignment - 1 Case A: Bernice Detwiler was a...

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1 Case A : Bernice Detwiler was a 73-year-old retired seamstress who had chronic obstructive pulmonary disease (COPD) secondary to a long history of smoking. Six months before her death, she was ex- amined by her physician. Her blood values at that time are shown in the Table 1 below. Table 1: 6 months before terminal admission Parameter Value PO 2 48 mm Hg (normal, 100 mm Hg) PCO 2 69 mm Hg (normal, 40 mm Hg) [HCO 3 - ] 34 mEq/L (normal, 24 mEq/L) pH 7.32 (normal, 7.4) Against her physician's warnings, Bernice adamantly refused to stop smoking. Six months later, Bernice was desperately ill and was taken to the emergency department by her sister. Her blood values and that time are shown in Table 2 below. Table 2: Terminal admission Parameter Value PO 2 35 mm Hg (normal, 100 mm Hg) PCO 2 69 mm Hg (normal, 40 mm Hg) [HCO 3 - ] 20 mEq/L (normal, 24 mEq/L) pH 7.09 (normal, 7.4) She remained in the hospital and died 2 weeks later. 1. When Bernice visited her physician 6 months before her death, what acid-base disorder did she have (Table 1)? Respiratory Acidosis; Bernice has shown a decrease in ventilation, increase in PCO 2 , de- crease in pH, increase in bicarbonate. 2.What was the cause of this disorder? Bernice’s smoking habits and COPD decreased her ventilation and thus lead to the changes in acid/base. 3.Why was her HCO 3 - concentration increased at the visit in Table 1? An increase in PCO2 drives the equilibrium to the right, increasing bicarbonate and hy-
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Acid Base Assignment - 1 Case A: Bernice Detwiler was a...

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