internal medicine
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الطب بطريقه سهله ...... حالات ، أسئلة شفوي
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ECG
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Forwarded from Yaqob Hamood
Real case :
PH : 7.49
PCO2 : 49.7
PO2 : 37.4
Na : 128
HCO3 : 36
BE: 14.5
What is your interpretation ?
Forwarded from Yaqob Hamood
💜 Respiratory Acidosis :
Acute Respiratory Acidosis :
💉ABG will show :
PH : Less than 7.35
CO2 is more than 45 mmHg
HCO3 normal
⬜️ Every increase 10 mmgh in CO2 above 40 mmHg , PH ⬇️ decrease 0.08 and HCO3 will ⬆️ increase by 1mEq/L
وكان ال acute respiratory Acidosis تساوي uncompensated respiratory Acidosis
Next will about
✔️ chronic respiratory Acidosis
✔️ Acute on top of chronic respiratory Acidosis
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Forwarded from Yaqob Hamood
Consider a case where the PaCO2 = 23 mm Hg, the pH = 7.54, and the HCO3 = 38 mEq/L ?
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Forwarded from Yaqob Hamood
"No pain No gain"
Forwarded from Yaqob Hamood
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
Forwarded from Yaqob Hamood
👨🏻‍⚕Is mmol/L equal mEq/ L ?
Forwarded from Yaqob Hamood
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
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 ??
internal medicine
🧑‍⚕A. As follows:
✓ Tricuspid regurgitation (TR)
✓ Ventricular septal defect (VSD).