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 Best of Five 113

 

   

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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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