ABR / Questions and case studies

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Questions
{The concentration of hydrogen ions (H +) in body fluids is in the order of: - A - μmol / l + B - nmol / l - C - mmol / l - D - pmol / l
 * type = "[]"}
 * The pH value of 7.40 corresponds to cH + 40 nmol / l.

The urinary excretion of H + in 24 hours in an adult is around: - A - 200 mmol - B - 40 μmol + C - 70 mmol - D - 7 mmol / l
 * type = "[]"}

{Serum buffer bases are given by: + A - [HCO 3 -] + [proteinate] - B - [Cl -] + [HCO 3 -] + [HPO 4 2−] + [lactate] - C - [HCO 3 -] + [CO 3 2−]
 * type = "[]"}
 * Serum buffer bases (BB) are given by the sum of hydrogen carbonate (24 mmol / l) and protein anion values ​​(18 mmol / l) and are therefore normally 42 mmol / l.

{Recognition of metabolic acidosis (MAC) in a mixed ABR disorder allows: + A - finding increased values ​​of "anion gap" + B - reduction of pO 2 in arterial or central venous blood + C - low hemoglobin in the blood + D - increased lactate in the blood
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{Significant hypoproteinemia with a decrease in residual anions leads to: ' + A - MAL - B - MAC - C - RAL + MAC - D - MAC + RAC
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 * The reduction of proteins together with the reduction of residual anions leads to the expansion of the "bicarbonate space" and thus to metabolic alkalosis

Patient with scoliosis and heart defect
A 17-year-old patient was admitted to hospital with a congestive heart defect and scoliosis. Upon admission, the laboratory was examined and again 24 hours later.

Power:
 * protein 1 g
 * pH = 6
 * 3-6 hyaline cylinders
 * other findings normal

 'Questions:' 
 * 1)  'What was the ABR failure on reception?' 
 * 2)  'What was the ABR disorder after 24 hours?' 
 * 3)  'What caused the decrease in serum K + in 24 hours?' 
 * 4)  'Does the clinical condition match the laboratory findings?' 

Patient in acute respiratory distress
A 51-year-old man was admitted to hospital with acute respiratory distress syndrome (Acute Respiratory Distress Syndrome). The patient smokes 3 packs of cigarettes a day.

 'Questions:' 
 * 1)  'How do you rate ABR at the time of admission?' 
 * 2)  'Is the oxyhemoglobin dissociation curve shifted?' 
 * 3)  'What is the significance of the other results?' 

Patient in diabetic coma
A 15-year-old girl is brought in a coma to ARO. She is a diabetic for 7 years, she took insulin. She already had several seizures hypoglycemia and ketoacidosis. She's been learning a lot at school lately and may have neglected some insulin injections.  'Questions:' 
 * 1) What is the diagnosis?
 * 2) Calculate the anion gap (AG), what is the cause of high AG?
 * 3) What is the significance of increased osmolality?
 * 4) Why are chlorides and HCO 3 - reduced, what is the meaning of "normal" Na + and increased K + ?

Patient with pulmonary insufficiency and hypokalemia
Patient 55 years old, with chronic pulmonary obstructive disease who has been treated with thiazide drugs for a long time (such as  diuretic).

Laboratory results on admission  'Questions:' 
 * 1)  'What ABR fault is this?' 

Related Articles

 * ABR
 * Acid-base imbalances
 * Diabetic ketoacidosis
 * Oxygen transport by blood

Source

 * ws:ABR/Otázky a kazuistiky