A 65-year old male hospital in-patient has smoked cigarettes since he was 18 years old.

Question:03
A 65-year old male hospital in-patient has smoked cigarettes since he was 18 years old. He has a chronic cough and marked sputum production. When his doctor starts to give him the usual talk about losing weight, he explains that since he has about fifty pounds to lose, he has tried to exercise, but is unable to because of shortness of breath with any activity. Upon further questioning, he comments that his symptoms have been present for a very long time, but he was hospitalized due to a marked exacerbation of his complaints. On auscultation, rhonchi and wheezes are heard. His laboratory results are as follows: pCO2 60 mm Hg(35-45 mm Hg) pH 7.34( 7.35-7.45) bicarbonate 31 mEq/L( 24 mEq/L) Na+ 140 mEq/L( 135-145 mEq/L) K+ 4.0 mEq/L( 3.5-5.5 mEq/L) Cl-100 mEq/L(98-109 mEq/L) What is the primary disorder?

a) metabolic acidosis with a normal anion gap
b) metabolic acidosis with an elevated anion gap
c) metabolic alkalosis
d) respiratory acidosis
e) respiratory alkalosis


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