Acid-Base Balance — Physiology

A 42-year-old woman with type 2 diabetes presents with nausea, vomiting, and rapid shallow breathing for 6 hours. Blood glucose is 420 mg/dL. Arterial blood gas: pH 7.18, PaCO₂ 22 mmHg, HCO₃⁻ 8 mEq/L, PaO₂ 95 mmHg. Serum electrolytes: Na⁺ 128 mEq/L, K⁺ 5.8 mEq/L, Cl⁻ 98 mEq/L. What is the primary acid-base disturbance, and what is the expected respiratory response?

A 58-year-old man with chronic obstructive pulmonary disease (COPD) presents to the emergency department with acute dyspnea and altered mental status. His wife reports he has been increasingly somnolent over the past 3 days. On examination, he is cyanotic and has pursed-lip breathing. Arterial blood gas analysis shows: pH 7.28, PaCO₂ 72 mmHg, HCO₃⁻ 32 mEq/L, PaO₂ 48 mmHg. What is the primary acid-base disturbance?

Which of the following is the most common primary acid-base disorder encountered in clinical practice?

Which of the following is the primary buffer system responsible for maintaining pH in the extracellular fluid?

A 42-year-old woman with type 2 diabetes mellitus presents with nausea, vomiting, and rapid shallow breathing. She has a 2-week history of poor glycemic control and missed insulin doses. Arterial blood gas analysis shows: pH 7.18, PaCO₂ 24 mmHg, HCO₃⁻ 9 mEq/L, anion gap 18 mEq/L. What is the primary acid-base disturbance, and what is the expected PaCO₂ for appropriate respiratory compensation?