If you find the material on this website useful, you will find that the two books ACES for PACES and KEYS to SUCCESS in Medicine complement the material on these sites and will enhance your studying and revision

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BOF: 113

A 74-year-old male who is known to have ischaemic heart disease and has had a myocardial infarction presents with breathlessness. His extremities are cold and clammy; his pulse rate is 120 beats per minute, blood pressure 80/40. JVP elevated, heart sounds triple rhythm, crepitations are heard in both bases.

Investigations show:

pH 7.24

Pa O₂ 8.5 kPa

Pa CO₂ 4.4 kPa

Blood lactate 5.9 mmol/l

Urine pH 5.2

Urine osmolarity 320mmol/l

Blood glucose 8.6 mmol/l

In this patient the abnormal acid-base balance is due to:

a)      Aspirin overdose

b)      D-lactic acidosis

c)      Type A L-lactic acidosis

d)      Type B L-lactic acidosis

e)      Diabetic ketoacidosis

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