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@ it is helpful to consider the primary acid-base disturbance. In this question, the hypotension in the setting of myocardial infarction suggests shock, which implies lactic acidosis due to anaerobic metabolism since the tissues are poorly perused. The primary disturbance is therefore metabolic acidosis, regardless of respiratory compensation. It is easier to do this when you are given a pH and can identify the primary disturbance (acidosis vs alkalosis) and then consider other data points such as serum HCO3, PCO2, etc to identify the source of the derangement. In certain cases like salicylate toxicity, however, you may have a combined respiratory and metabolic acid base disturbance resulting in a normal pH, which can be potentially confusing.
Respiratory compensation isn’t same as respiratory alkalosis. If you say the latter, it implies there’s a pathology there, like with aspirin where it’s mixed
At first glance, I thought ST-elevation of II, III, and aVF indicated RCA infarct but the answer was not there. so now we have to look at other leads? ST elevation of Anterior precordial leads indicated LAD. Thus the best answer is LAD, which also makes sense because LAD branches out of RCA.
Our New USMLE Telegram group (link valid at least at time of this clip): t.me/+mSDYK3fV2wdkNmY0
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X (Twitter)): x.com/mehlman_medical
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Mehlman HY Internal Med PDF: mehlmanmedical.com/hy-internal-medicine/
Wont there be hyperventilation during MI?
Even if there is from pulmonary edema that’s not primary or salient acid base disturbance
Good morning and good question!!
how long does it take to set up "compensatory Respiratory Alkalosis" ?
Minutes. The only thing that has to change is the respiratory rate, assuming no underlying pulmonary pathology.
@@jamesvithoulkas9151 what if someone confuse it with resp alkalosis in this question? or the word compensatory will always be there?
@ it is helpful to consider the primary acid-base disturbance. In this question, the hypotension in the setting of myocardial infarction suggests shock, which implies lactic acidosis due to anaerobic metabolism since the tissues are poorly perused. The primary disturbance is therefore metabolic acidosis, regardless of respiratory compensation.
It is easier to do this when you are given a pH and can identify the primary disturbance (acidosis vs alkalosis) and then consider other data points such as serum HCO3, PCO2, etc to identify the source of the derangement. In certain cases like salicylate toxicity, however, you may have a combined respiratory and metabolic acid base disturbance resulting in a normal pH, which can be potentially confusing.
Respiratory compensation isn’t same as respiratory alkalosis. If you say the latter, it implies there’s a pathology there, like with aspirin where it’s mixed
At first glance, I thought ST-elevation of II, III, and aVF indicated RCA infarct but the answer was not there. so now we have to look at other leads? ST elevation of Anterior precordial leads indicated LAD. Thus the best answer is LAD, which also makes sense because LAD branches out of RCA.
Bro you’re cooked
Got the answer. Thank you.
Thank you Mike ❤my favourite topic
Excellent revision. Thanks
High yield one ❤❤❤❤
thanks dr mike