[Solved]: A 57-year-old man is admitted because of…

A 57-year-old man is admitted because of breathlessness and wheezing. He is known to suffer from chronic obstructive pulmonary disease; medications included inhalers and oral prednisolone. He is also a heavy smoker. On examination, he is breathless, cyanosed and pyrexial. His chest is hyper-resonant and he has generally decreased air entry with bilateral wheeze and coarse crepitations on the right side. Chest X-ray shows probable collapse of the right upper lobe and emphysematous changes. Arterial blood gases on air show: H+. 56 mmol/L (35-45) PCO2. 11.3 kPa (4.5-5.6) HCO3. 36 mmol/L (21-28) PO2. 7.1 kPa (12-15) (a) Describe the acid base abnormality. (b) What background acid-base picture might you anticipate if he was not acutely breathless? (c) Make up a set of acid-base results that would be consistent with your answer to part (b).