A 86 year old female presented with sudden onset breathlessness since morning along with chest pain. O/E RR- 45Bpm, BP-120/70mmHg, Chest : B/L crepitation. ABG :pH :7.114, PCO2 : 15.7, HCO3- :4.8mEq/L, Lactate : 12.9mmol, Na+ : 135 mEq/l, Cl- : 111 mEq/l, K+ : 6.6 mEq/L
Step 1 : Acidosis (pH<7.114)
Step 2 :Metabolic Acidosis (HCO3- <24)
Step 3 : Anion gap = 135 – (111 +4.8) = 19.2
Step 4 :
Step 5 :
Answer : The ABG shows Primary compensated WAGA (Lactic Acidosis) along with concomitant non gap acidosis.
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