Correct!
2. Metabolic acidosis
The patient has a low pH of 7.08 which is below the normal pH of 7.40, so the patient has an acidosis. The pCO2 is low at 18 compared to the normal 40. Therefore, the patient has a metabolic acidosis rather than a respiratory acidosis. In fact, the patient is hyperventilating resulting in a low pCO2 partially compensating for her acidosis and explaining her tachypnea.
Metabolic acidosis results from accumulation of an acid and is divided into two groups-normal anion gap and high anion gap. The anion gap is calculated by the following formula: Anion Gap = Sodium - (Chloride + Bicarbonate). There are a small of anions not accounted for by the formula so a normal anion gap is 8-16. The current patient’s anion gap is high:
Na+ 136-(Cl- 103+Bicarbonate 4) =Anion gap 19
Which of the following are causes of high anion gap metabolic acidosis? (Click on the correct answer to be directed to the fourth of five pages)