---

Question 1

A 70 yo male smoker presents to ED with acute dyspnoea. This is his ABG on room air:

pH 7.30
pCO₂ 60
PO₂ 60
Na 135
Cl 100
HCO₃ 30

1. What is the primary disturbance?
2. Is this acute or chronic?

Question 2

A 22 yo female presents with acroparaesthesiae. This is her ABG on room air:

pH 7.48
pCO₂ 30
PO₂ 90
Na 140
Cl 110
HCO₃ 22

1. What is the primary disturbance?
2. What is the likely cause?

Question 3

A 32 yo male alcoholic presents obtunded. This is his ABG on room air:

pH 6.9
pCO₂ 29
PO₂ 100
Na 140
Cl 101
HCO₃ 5

1. Interpret this blood gas.
2. What is the likely cause of this abnormal gas?

Question 4

A 68 yo male presents with a 3 day history of diarrhoea. His blood gas shows:

pH 7.34
pCO₂ 34
PO₂ 80
Na 135
Cl 108
HCO₃ 18

1. What is the primary disturbance?
2. What is the likely cause?

Question 5

A 20 yo female presents GCS 9/15 after binge drinking this evening. Her blood gas shows:

pH 7.5
pCO₂ 44
PO₂ 100
Na 139
Cl 100
HCO₃ 30

1. What is the primary disturbance?
2. Give three causes of this abnormality.
3. Is another concurrent process present?

Question 6

A 38 yo type 1 diabetic presents with three days of diarrhoea and coughing. This is his ABG on room air:

pH 7.31
pCO₂ 10
Na 123
Cl 99
HCO₃ 5

1. Describe this blood gas.
2. What is the likely cause of the primary abnormality?
3. How many processes are going on?
4. Given the most likely cause of each process on this gas.

Question 7

A 55 yo female presents with five day history of vomiting. This is her ABG on room air:

pH 7.23
pCO₂ 22
Na 140
Cl 77
HCO₃ 9

1. Describe this blood gas.
2. Is compensation as expected?
3. Is another process going on?

Question 8

A 39 yo male alcoholic presents with vomiting. His blood gas shows:

pH 7.20
pCO₂ 25
Na 130
Cl 80
HCO₃ 10

1. Describe this blood gas.
2. What is the likely cause of this?

Question 9

A Crohn’s patient presents with 3 days of vomiting and diarrhoea. A blood gas shows:

pH 7.36
pCO₂ 22
Na 147
Cl 121
HCO₃ 14

1. Describe this blood gas.
2. Is another process going on?
3. Give a possible cause for each of the three abnormalities/processes.

Question 10

A diabetic alcoholic with known cirrhosis presents with malaise. Blood gas shows:

pH 7.46
pCO₂ 17
Na 133
Cl 84
HCO₃ 15

1. Describe this blood gas.
2. Give a likely cause for each of the three processes evident on this gas.

Question 11

A 35 yo female presents with pneumonia. This is her ABG on room air:

pH 7.52
pCO₂ 30
PO₂ 60
Na 145
Cl 98
HCO₃ 21

1. What three processes are evident on this gas?
2. Give a reasonable cause for each process.

Question 12

A 50 yo male type 1 diabetic presents with 3 days of lethargy. He is on a “fluid pill” but cannot recall its name.

pH 7.41
pCO₂ 32
Na 130
K 2.7
Cl 79
HCO₃ 19
Glu 45

1. Describe this blood gas.
2. Is there compensation? If so, what?
3. Is a third process present?

Question 13

A 60 yo homeless person is BIBA after two days of nausea, vomiting, and anorexia. This is his ABG on room air:

pH 7.3
pCO₂ 29
Albumin 10
Na 132
K 5.0
Cl 104
HCO₃ 16
Glu 4

1. Describe this blood gas.
2. Is there compensation? If so, what?

Question 14

A 56 yo female presents with fever of unknown origin. Her blood gas shows:

pH 7.18
pCO₂ 32
Na 138
Cl 98
HCO₃ 18

1. Describe this blood gas.
2. Is compensation present, and if so, is it adequate?
3. Is another process present, and if so, what?

Question 15

A 72 yo male with a history of COPD presents with alcoholic ketosis. This is his ABG on room air:

pH 7.2
pCO₂ 60
Na 136
K 5.1
Cl 85
HCO₃ 25

1. What was his HCO3 prior to the onset of ketosis? Assume only one process is present.

Question 16

An 87 yo female with a history of asthma presents with dyspnoea. This is her ABG on 40% oxygen:

pH 7.4
pCO₂ 46
PO₂ 100
HCO₃ 28

1. What is her Aa gradient?
2. What two processes are evident on the gas?

Question 17

A 78 yo male presents with acute dyspnoea. His ABG on 40% oxygen is shown:

pH 7.48
pCO₂ 42.1
PO₂ 142
Na 143
K 3.6
Cl 105
HCO₃ 31.3

1. Describe this blood gas.
2. What is the Aa gradient?

Question 18

An 86 yo female with a history of smoking presents with acute dyspnoea and fever. This is her ABG on 44% oxygen:

pH 7.36
pCO₂ 50
PO₂ 69
HCO₃ 28

1. Describe this blood gas.
2. Is compensation acute or chronic?
3. What is the Aa gradient?

Question 19

A 57 yo male presents with dyspnoea for 2 days. This is his ABG on 60% oxygen:

pH 7.11
pCO₂ 91
PO₂ 105
Na 144
K 4.2
Cl 106
HCO₃ 28

1. Describe this blood gas.
2. What is the Aa gradient?

Question 20

An 86 yo female from a HLCNH presents with fever and malaise for three days. This is her ABG on room air:

pH 7.26
pCO₂ 40
PO₂ 88
Na 135
K 4
Cl 107
HCO₃ 21

1. Describe this blood gas.
2. Give three causes of this abnormality.

Question 21

A 78 yo female presents with malaise. Her ABG on 36% oxygen is as follows:

pH 7.46
pCO₂ 57
PO₂ 27 (no, this is NOT a typo!)
Na 140
K 3.1
Cl 88
HCO₃ 41

1. Describe this blood gas.
2. Is there evidence of another process?
3. What is the Aa gradient?
4. Why was this lady able to talk full sentences?

Question 22

An ABG is taken from a 57 yo male alcoholic smoker on 60% oxygen. The ABG shows:

pH 7.11
pCO₂ 91
PO₂ 105
Na 144
K 4.2
Cl 106
HCO₃ 28
Glu 16.1
Lac 1.3
BE -1.2

1. Describe this blood gas.
2. What is the Aa gradient?
3. Give three combinations of processes that may explain this blood gas.

Question 23

The following bloods were taken from a 30 yo male cricketer:

Bili 169
GGT 381
ALP 96
ALT 4149
AST 5017
Lipase 92
CK 107

1. What is the main abnormality on this blood panel?
2. Give a likely cause of this, given the brief history.