🧑🏼‍⚕A. Because:
✓ Systolic thrill in mitral area
✓ First heart sound is soft
✓ There is a PSM radiating to the left axilla.

Real case ABG
PH = 6.98
CO2 = 12 mmHg
HCO3 = 4.4 mmol/L
Read this ABG ?

🧑‍⚕Firstly Acidosis
👨‍⚕ Why ?
🧑‍⚕PH less than 7.35
👨‍⚕ Metabolic or respiratory?
🧑‍⚕ Metabolic
👨‍⚕ Why ?
🧑‍⚕ Because Bicarbonate is low and CO2 is low , Co2 low as compensation
👨‍⚕is compensation or partially compensation or not compensation ?
🧑‍⚕ partial compensation
👨‍⚕ Why ?
🧑‍⚕ Because CO2 low PH low
👨‍⚕ Why you didn't say compelet compensation ?
🧑‍⚕ Because in compelet compensation PH must be normal , in this case PH is abnormal
👨‍⚕ Why you didn't say uncompensation ?
🧑‍⚕ Firstly HCo3 it's primary disorder as it's low and PH is low ....if uncompensation CO2 must be normal
👨‍⚕ok .... what you want to see after your dx as Metabolic Acidosis ?
🧑‍⚕i will calculate Anion Gap
👨‍⚕ Why ?
🧑‍⚕ To know the cause of metabolic acidosis ,,as there is causes of metabolic Acidosis with normal Anion Gap ,,also there's causes for High anion Gap Metabolic Acidosis
👨‍⚕ How you calculate Anion Gap ?
What is the causes of High Anion Gap Metabolic Acidosis , causes of Normal Anion Gap Metabolic Acidosis ?
🧑‍⚕ Let members Answer , help me members ?

Real case :
PH : 7.49
PCO2 : 49.7
PO2 : 37.4
Na : 128
HCO3 : 36
BE: 14.5
What is your interpretation ?

Consider a case where the PaCO2 = 23 mm Hg, the pH = 7.54, and the HCO3 = 38 mEq/L ?

This case metabolic alkalosis

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"No pain No gain"

A 78-year-old man is brought in from home after a 3-day history of diarrhoea. His Arterial blood gas
shows:
• pH 7.27 (7.35–7.45)
• HCO3 −. 14 mmol/L (22–24)
• PCO2 28 mmol/L (35–45)
• K+ 2.6 mmol/L (3.5–5.0)
• Na+ 134 mmol/L (135–145)
• Cl− 113 mmol/L (95–105)
• Ur 14 mmol/L (2–7)
• Cr 320 mmol/L (50–100)
• lactate 1.5 mmol/L (<2.2).
Which ONE of the following options would BEST explain the clinical scenario?
A. High AG metabolic acidosis secondary to renal failure
B. High AG metabolic acidosis secondary to dehydration and lactic acidosis
C. Normal AG metabolic acidosis secondary to diarrhoea
D. Concurrent normal AG metabolic acidosis and respiratory alkalosis

Answer in Detail :
https://t.me/Yaqob_Hamood/70

C

👨🏻‍⚕Is mmol/L equal mEq/ L ?

A 35-year-old female presents with a prolongedseizure. Her initial ABG is shown.
• pH 7.25 (7.35–7.45)
• PCO2 55 mmol/L (35–45)
• PO2 100 mmol/L (80–100)
• HCO3 15 mmol/L (22–24)
• Na+ 135 mmol/L (135–145)
• K+ 4.5 mmol/L (3.5–5)
• Cl- 98 mmol/L (95–105).
Which ONE of the following explains the aboveblood gas?
A. Mixed normal AG metabolic acidosis andrespiratory acidosis
B. High AG metabolic acidosis
C. Mixed high AG metabolic acidosis and metabolicalkalosis
D. Mixed high AG metabolic acidosis andrespiratory acidosis

D is the best Answer

in text books and lectures , statement : excess CO2 production in the body leads to acidosis

my confusion : even if tons of CO2 being produced , what matters ??

CO2 reacts with H20 and is converted to H2CO3 and dissociates to H+ & HCO3-

H+ is an acid while bicarbonate is a base , which neutralizes each other .

so what's the problem with excess CO2 ??

isn't it a self-solved issue ??

،this question is from member ?

👨🏻‍⚕ why No one Answer?