A 35 year old female with AIDS is brought into the Emergency Department with a f

Question

A 35 year old female with AIDS is brought into the Emergency Department with a fever of 39oC ad a three month history of copious diarrhea.   On physical exam, the patient is a thin female with moderate distress. Vital signs are blood pressure (100/60), pulse 100, and respiratory rate of 18.

Na+ = 136pH = 7.35

K+ = 3.4Paco2 = 27

BUN = 30HCO3- = 14

Glu = 105

HCO3-= 14

Review the case and list the critical concerns for this patient (her K+ is low). What acid/base disturbance would you expect to see with this patient based on the physical exam?

Explanation / Answer

Diarrhea caused by cryptosporidium is an opportunistic infection in aids causing diarrhea lasting for months, causing malabsorption(which leads to loss of K+ ions leading to hypokalemia), fevers , metabolic and acid base disorders. Exces of fluid loss in patient lead to decrease in Blood pressurewhich was found to be 100/60 . To pump such a low pressure blood heart pump faster at a rate of 100 bpm.

Ion Disturbance - Hypokalemia

the main reason for hypokalemia or less k+ ions in aids are gastro intestinal pottasium losses which is usually induced by profuse diarrhea secondary to intestinal infection.

Acid base disorders

Acidosis is the process characterized by either a primary acid gain or a primary alkali loss, while acedemia indicates an increased H+ concentration in the blood (blood pH < 7.34).

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