Case 6
A 32 year-old salesman returns from a vacation in Guatamala. He complains of severe vomiting for five days. He appears extremely fatigued, and has sunken eyes, dry mucous membranes, a heart rate of 110 and a blood pressure of 90/50. When he stands, his blood pressure falls, and his heart rate increases.
Electrolytes: Na+ 146, Cl- 98, HCO3- 38.
ABG 7.50 / 47 / 80
Q. Name the acid-base disorder.
Q. What is the approximate A-a gradient?
2 mm Hg
5 mm Hg
10 mm Hg
20 mm Hg
A. The acid-base disturbance is chronic metabolic alkalosis.
A. The A-a gradient is approximately 10 mm Hg.