Acid-Base work book - Precious Bodily Fluids - Free Printable

To determine the primary acid-base disorder for each set of arterial blood gas (ABG) values, we need to analyze the pH, pCO₂, and HCO₃⁻ levels. Here's a step-by-step approach to solving this problem:

Key Concepts:

1. pH:
- Acidemia: pH < 7.35
- Alkalemia: pH > 7.45
- Normal: 7.35–7.45

2. pCO₂:
- Respiratory Acidosis: pCO₂ > 45 mmHg
- Respiratory Alkalosis: pCO₂ < 35 mmHg
- Normal: 35–45 mmHg

3. HCO₃⁻:
- Metabolic Acidosis: HCO₃⁻ < 22 mEq/L
- Metabolic Alkalosis: HCO₃⁻ > 26 mEq/L
- Normal: 22–26 mEq/L

4. Compensation:
- In respiratory disorders, the kidneys compensate by adjusting HCO₃⁻.
- In metabolic disorders, the lungs compensate by adjusting pCO₂.

Steps to Solve:

1. Identify the primary disorder based on pH, pCO₂, and HCO₃⁻.
2. Check for compensation by comparing the observed values with expected compensatory changes.
3. Determine if there is a mixed disorder if both respiratory and metabolic components are present.

Analysis of Each Case:

#### Case 1: pH = 7.27, pCO₂ = 34, HCO₃⁻ = 15
- pH: Acidemia (pH < 7.35)
- pCO₂: Normal (35–45 mmHg)
- HCO₃⁻: Low (Metabolic Acidosis)
- Conclusion: Primary Metabolic Acidosis

#### Case 2: pH = 7.34, pCO₂ = 50, HCO₃⁻ = 26
- pH: Near normal
- pCO₂: High (Respiratory Acidosis)
- HCO₃⁻: Normal
- Conclusion: Primary Respiratory Acidosis

#### Case 3: pH = 7.45, pCO₂ = 48, HCO₃⁻ = 32
- pH: Alkalemia (pH > 7.45)
- pCO₂: High (Respiratory Acidosis)
- HCO₃⁻: High (Metabolic Alkalosis)
- Conclusion: Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)

#### Case 4: pH = 7.32, pCO₂ = 28, HCO₃⁻ = 14
- pH: Acidemia
- pCO₂: Low (Respiratory Alkalosis)
- HCO₃⁻: Low (Metabolic Acidosis)
- Conclusion: Mixed disorder (Primary Respiratory Alkalosis with Metabolic Acidosis)

#### Case 5: pH = 7.37, pCO₂ = 50, HCO₃⁻ = 28
- pH: Near normal
- pCO₂: High (Respiratory Acidosis)
- HCO₃⁻: High (Metabolic Alkalosis)
- Conclusion: Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)

#### Case 6: pH = 7.36, pCO₂ = 80, HCO₃⁻ = 44
- pH: Near normal
- pCO₂: Very high (Severe Respiratory Acidosis)
- HCO₃⁻: High (Metabolic Alkalosis)
- Conclusion: Mixed disorder (Primary Severe Respiratory Acidosis with Metabolic Alkalosis)

#### Case 7: pH = 7.32, pCO₂ = 36, HCO₃⁻ = 18
- pH: Acidemia
- pCO₂: Normal
- HCO₃⁻: Low (Metabolic Acidosis)
- Conclusion: Primary Metabolic Acidosis

#### Case 8: pH = 7.36, pCO₂ = 48, HCO₃⁻ = 26
- pH: Near normal
- pCO₂: High (Respiratory Acidosis)
- HCO₃⁻: Normal
- Conclusion: Primary Respiratory Acidosis

#### Case 9: pH = 7.43, pCO₂ = 45, HCO₃⁻ = 29
- pH: Alkalemia
- pCO₂: Normal
- HCO₃⁻: High (Metabolic Alkalosis)
- Conclusion: Primary Metabolic Alkalosis

#### Case 10: pH = 7.47, pCO₂ = 54, HCO₃⁻ = 38
- pH: Alkalemia
- pCO₂: High (Respiratory Acidosis)
- HCO₃⁻: High (Metabolic Alkalosis)
- Conclusion: Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)

#### Case 11: pH = 7.45, pCO₂ = 18, HCO₃⁻ = 12
- pH: Alkalemia
- pCO₂: Very low (Severe Respiratory Alkalosis)
- HCO₃⁻: Low (Metabolic Acidosis)
- Conclusion: Mixed disorder (Primary Severe Respiratory Alkalosis with Metabolic Acidosis)

#### Case 12: pH = 7.25, pCO₂ = 14, HCO₃⁻ = 8
- pH: Acidemia
- pCO₂: Very low (Severe Respiratory Alkalosis)
- HCO₃⁻: Low (Metabolic Acidosis)
- Conclusion: Mixed disorder (Primary Severe Respiratory Alkalosis with Metabolic Acidosis)

#### Case 13: pH = 7.32, pCO₂ = 46, HCO₃⁻ = 26
- pH: Acidemia
- pCO₂: High (Respiratory Acidosis)
- HCO₃⁻: Normal
- Conclusion: Primary Respiratory Acidosis

#### Case 14: pH = 7.28, pCO₂ = 68, HCO₃⁻ = 36
- pH: Acidemia
- pCO₂: Very high (Severe Respiratory Acidosis)
- HCO₃⁻: High (Metabolic Alkalosis)
- Conclusion: Mixed disorder (Primary Severe Respiratory Acidosis with Metabolic Alkalosis)

#### Case 15: pH = 7.38, pCO₂ = 37, HCO₃⁻ = 21
- pH: Near normal
- pCO₂: Normal
- HCO₃⁻: Low (Metabolic Acidosis)
- Conclusion: Primary Metabolic Acidosis

#### Case 16: pH = 7.44, pCO₂ = 48, HCO₃⁻ = 29
- pH: Alkalemia
- pCO₂: High (Respiratory Acidosis)
- HCO₃⁻: High (Metabolic Alkalosis)
- Conclusion: Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)

#### Case 17: pH = 7.45, pCO₂ = 28, HCO₃⁻ = 22
- pH: Alkalemia
- pCO₂: Low (Respiratory Alkalosis)
- HCO₃⁻: Normal
- Conclusion: Primary Respiratory Alkalosis

#### Case 18: pH = 7.52, pCO₂ = 58, HCO₃⁻ = 34
- pH: Alkalemia
- pCO₂: High (Respiratory Acidosis)
- HCO₃⁻: High (Metabolic Alkalosis)
- Conclusion: Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)

#### Case 19: pH = 7.33, pCO₂ = 34, HCO₃⁻ = 13
- pH: Acidemia
- pCO₂: Normal
- HCO₃⁻: Low (Metabolic Acidosis)
- Conclusion: Primary Metabolic Acidosis

#### Case 20: pH = 7.34, pCO₂ = 56, HCO₃⁻ = 29
- pH: Near normal
- pCO₂: High (Respiratory Acidosis)
- HCO₃⁻: High (Metabolic Alkalosis)
- Conclusion: Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)

Final Answers:

1. Primary Metabolic Acidosis
2. Primary Respiratory Acidosis
3. Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)
4. Mixed disorder (Primary Respiratory Alkalosis with Metabolic Acidosis)
5. Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)
6. Mixed disorder (Primary Severe Respiratory Acidosis with Metabolic Alkalosis)
7. Primary Metabolic Acidosis
8. Primary Respiratory Acidosis
9. Primary Metabolic Alkalosis
10. Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)
11. Mixed disorder (Primary Severe Respiratory Alkalosis with Metabolic Acidosis)
12. Mixed disorder (Primary Severe Respiratory Alkalosis with Metabolic Acidosis)
13. Primary Respiratory Acidosis
14. Mixed disorder (Primary Severe Respiratory Acidosis with Metabolic Alkalosis)
15. Primary Metabolic Acidosis
16. Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)
17. Primary Respiratory Alkalosis
18. Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)
19. Primary Metabolic Acidosis
20. Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)

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1. \text{Primary Metabolic Acidosis} & 11. \text{Mixed disorder (Primary Severe Respiratory Alkalosis with Metabolic Acidosis)} \\
2. \text{Primary Respiratory Acidosis} & 12. \text{Mixed disorder (Primary Severe Respiratory Alkalosis with Metabolic Acidosis)} \\
3. \text{Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)} & 13. \text{Primary Respiratory Acidosis} \\
4. \text{Mixed disorder (Primary Respiratory Alkalosis with Metabolic Acidosis)} & 14. \text{Mixed disorder (Primary Severe Respiratory Acidosis with Metabolic Alkalosis)} \\
5. \text{Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)} & 15. \text{Primary Metabolic Acidosis} \\
6. \text{Mixed disorder (Primary Severe Respiratory Acidosis with Metabolic Alkalosis)} & 16. \text{Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)} \\
7. \text{Primary Metabolic Acidosis} & 17. \text{Primary Respiratory Alkalosis} \\
8. \text{Primary Respiratory Acidosis} & 18. \text{Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)} \\
9. \text{Primary Metabolic Alkalosis} & 19. \text{Primary Metabolic Acidosis} \\
10. \text{Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)} & 20. \text{Mixed disorder (Primary Respiratory Acidosis with Metabolic Alkalosis)} \\
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