A middle-aged woman came to the emergency department with worsening dyspnea, pressure in head and increased respiratory rate. She was known to have pulmonary edema secondary to heart failure. On examination, there was tachycardia, tachypnea, and hypertension. ABGs were carried out which showed pH < 7.35, paCO2>42 mm of HG, and H2CO3 was also high. What is the likely diagnosis?
  1. Respiratory alkalosis
  2. Metabolic acidosis
  3. Respiratory acidosis
  4. Metabolic alkalosis
Answer- C - The most likely diagnosis in the patient with pulmonary edema presenting with increased respiratory rates is respiratory acidosis because ph < 7.35, paCO2 >42 mm of Hg and H2CO3 is also high. These, along with her symptoms of worsening dyspnea and pressure in the head are all indicators of respiratory acidosis.
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