00:01
So, it has been given that a patient has undergone a surgery and we have to aspirate him for the content of his upper gastrointestinal tract.
00:11
And these are the following that has been obtained from his arterial blood sample.
00:17
So as you can see that the ph is 7 .55.
00:20
So normal ph is from the range 7 .35 to 7 .45.
00:25
So if it is more than 7 .55, that means here alkalosis is occurring.
00:33
If it was less then it would have been acidosis.
00:35
Then we see that the pco2 is 55 mm hg and hco3 is 40 mm mole per liter.
00:43
So that means what? it means that metabolic alkalosis is present.
00:50
That means the cause of alkalosis was due to metabolic reason.
00:53
And the carbon dioxide, it is increased so that it can compensate for the alkalosis here.
01:02
So it is compensating.
01:04
Now in case of pco2, the normal range is 35 to 45.
01:12
Whereas here you can see it is 52.
01:15
And in case of hco3 it is 22 to 26.
01:20
Whereas you can see it is 40.
01:21
So in this case what is happening that the ph level is increased.
01:27
And that is due to the metabolic reason.
01:30
And this lead to the increase of bicarbonate level.
01:36
Bicarb level also increased due to that.
01:38
So this is metabolic acidosis.
01:41
And the pco2 level here is increased.
01:43
Why? so that it can compensate for the respiratory.
01:47
Now they have asked us that how we can compensate for it.
01:52
So the thing is the pco2 as i said, the pco2 increase is compensating for the alkalosis.
02:02
But the ph level have not yet back to normal.
02:07
So it is an incomplete compensation.
02:10
The compensation formula for metabolic alkalosis is expected pco2 equal to 0 .7 hco3 plus 20.
02:27
So the hco3 here we know is 0 .7 into 40 plus 20.
02:34
So it is giving us 48 mmhg.
02:38
That is expected.
02:40
But what is present in reality it is how much? that is 52.
02:46
So that is why it is not compensating completely.
02:49
It is an incomplete compensation.
02:52
That is the answer.
02:55
So in the next part of the question it has been said that a young woman has been found in a comatose condition.
03:04
Because she has taken an unknown number of sleeping pill for an unknown amount of time.
03:09
Okay and we have taken arterial blood sample from this woman.
03:17
And in the sample we see that the ph is around 6 .90.
03:25
The bicarbonate amount, this is about 13 meq per litre.
03:36
And the partial pressure of carbon dioxide it is around 68 mmhg.
03:43
Now we have to accurately describe based on this acid -base status among the following option what does the patient have.
03:52
Now this indicates what? from the following chart what we can see is that the ph is toward an acidic side...
