Blog | Friday, October 12, 2012

Guess the diagnosis of an acid-base problem-part 1


Recently I heard about this patient: A man with a history of ulcerative colitis and PSC who had had both a colectomy with end ileostomy and liver transplant in the past. Now he presents with dyspnea and fatigue and increased stool output.

Your job is to let me know how to evaluate the patient further and define the acid-base problem.

VS P 90 R 20 BP 95/70 T afebrile, otherwise the exam is normal:
129,103,82,140
6.2,11,6.2,7.6
albumin 2.7

pH:7.27

pCO2: 26

pO2: 105

calc HCO3: 12

Have fun! Parts 2 and 3 will come out on consecutive Fridays.

db is the nickname for Robert M. Centor, MD, FACP. db stands both for Dr. Bob and da boss. He is an academic general internist at the University of Alabama School of Medicine, and is the Associate Dean for the Huntsville Regional Medical Campus of UASOM. He also serves as a frequent ward attending at the Birmingham VA Hospital. This post originally appeared at his blog, db's Medical Rants.