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Pediatrics JIPMER 2018 a7735b5b

In exhausted child with severe bronchiolitis, for every 10 mm Hg increase in PCO2, how many milliEq of bicarbonate will increase:-

A
2
B
4
C
8
D
1
High-Yield Explanation
Bronchiolitis is most common type of acute lower respiratory tract infections in children and young infants. Most common causative agent is respiratory syncytial virus. It's mostly seen in age group 6months to 3years C/F hyperinflated chest, respiratory distress of varying degree, hypoxia. Rx is mainly suppoive as no role of antibiotics as it's a viral infection. When pco2 is increased results is respiratory acidosis. In order to compensate that body tries to save more bicarbonate. Compensation in primary respiratory disorders For every 10 mm increase in pco2: DISORDER RESPIRATORY ACIDOSIS RESPIRATORY ALKALOSIS Acute HCO3 increases by 1 HCO3 decreases by 2 Chronic HCO3 increased by 3.5 HCO3 decreases by 4 Compensation in metabolic disorders DISORDER EXPECTED COMPENSATION Metabolic acidosis PCO2 = 1.5 * (HCO3) + 8 +/-2 Metabolic alkalosis pco2 increases by 7 for each 10 mEq/L increases in H From the above picture we see that for every acute process hco3 increases by 1 in respiratory acidosis

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