Arterial Blood Gas Practice Questions
Assume the ABG is interpretable. Assess the ABG for acid/base status.
1. A 62 year old male presents with a 3 day history of a productive cough with yellow
sputum, dyspnea, fever and pleuritic chest pain. Chest X-ray is significant for a left
lower lobe pneumonia. His ABG in the Emergency Department is: 7.27/58/60 on 5L by
nasal cannula, HCO3- 26, anion gap is 10, albumin is 4.0.
2. A 32 year old female with obsessive compulsive disorder presents to the emergency
department with a severe anxiety attack. She says that she has chest pain, shortness of
breath, tingling in her hands and feet and that she feels like she is going to pass out. On
physical exam her respiratory rate is 35, her heart rate is 120 and the rest of her exam is
within normal limits. Her ABG in the Emergency Department is: 7.54/24/99 on room air,
HCO3- 20, anion gap is 10, albumin is 4.0.
3. 55 year old male who has had persistent vomiting for three days. His ABG in the
Emergency Department is: 7.58/55/80 on room air, HCO3- 46, anion gap is 10, albumin
is 4.0.
4. A 40 year female with past medical history significant for cirrhosis of the liver secondary
to alcoholism has an ABG performed when she is found to have a HCO3- of 17 on her
basic metabolic panel drawn during her new patient visit. The ABG is 7.46/20/80 on
room air, HCO3- 16, anion gap = 10, albumin = 4.0.
5. An 18 year old male with ulcerative colitis presents with profuse diarrhea for three days.
In the Emergency department his HCO3- is 13 on his basic metabolic panel. An ABG is
obtained and it is: 7.28/27/90 on room air, HCO3- 13, anion gap = 10, albumin = 4.0.
Arterial Blood Gas Practice Questions
6. A 55 year old male with idiopathic pulmonary fibrosis presents with abdominal pain.
ABG is 7.35/52/50 on room air, HCO3- 27, anion gap = 10, albumin = 4.0.
7. The ABG on a 27 year old pregnant woman is 7.43/30/95 on room air, HCO3- 20, anion
gap = 10, albumin = 4.0.
8. A 75 year old male with hypertension, hyperlipidemia, stage III congestive heart failure
secondary to ischemic cardiomyopathy presents for a routine appointment. He takes 40
mg of furosemide twice daily. His HCO3- on basic metabolic panel is 36 so an ABG is
performed. The ABG is 7.48/49/75 on room air, HCO3- 37, anion gap = 10, albumin = 4.0.
9. A 35 year female physician with a history of asthma and severe allergies to pollen
develops urticaria, hypotension and stridor when she puts on a pair of latex gloves. In
the Emergency Department her ABG is 7.21/64/70 on room air, HCO3- 26, anion gap =
10, albumin = 4.0.
10. 26 year old male with a history of insulin dependent diabetes Type I since age 7, chronic
kidney disease with a baseline creatinine of 2.5 presents with shortness of breath, cough
with productive green sputum, blurry vision, polydipsia and polyuria. His CXR is
significant for bilateral infiltrates. His blood sugar is 600. His urine is positive for
ketones. Sputum gram stain is significant for gram positive diplococci. In the
Emergency Department his ABG is 7.19/35/60 on 7 liters of O2, HCO3- 9, anion gap = 18,
and albumin = 4.0. Serum [K+] is 5.9 meq/L and creatinine is 4.5 mg/dL.
11. 77 year old male with a long history of COPD and congestive heart failure (ejection
fraction of 35%) presents with a CHF exacerbation. He is admitted to the hospital and
aggressively diuresed for two days with intravenous furosemide. On day 3 of his
hospitalization he has some chest pain. As a part of the work up of his chest pain an ABG
is obtained. The ABG is 7.54/80/65 on 2L, HCO3- 54, anion gap = 12, albumin = 4.0.
Arterial Blood Gas Practice Questions
12. 25 year old G1P0 woman who is 6 months pregnant presents with a 3 day history of
vomiting from viral gastroenteritis. The ABG in the Emergency Department is 7.6/30/83
on room air, HCO3- 28, anion gap = 12, albumin = 4.0.
13. 75 year old male with a history systolic congestive heart failure (ejection fraction is 35%)
and chronic kidney disease stage II presents with a three day history of increasing
dyspnea, 10 lb weight gain, lower extremity edema and orthopnea. His creatinine is at
his baseline. His ABG in the Emergency Department is 7.25/46/78 on 2L, HCO3- 20,
anion gap = 10, albumin = 4.0.
14. 88 year old female with history of tobacco abuse, diabetes mellitus type II presents with
severe abdominal pain. Her physical exam is pain out of proportion to her exam. Her
lactate level is elevated. Her basic metabolic panel shows a HCO3- of 10 so an ABG is
obtained. The ABG is 7.15/22/75 on room air, HCO3- 9, anion gap = 10, albumin = 2.0.
Her serum creatinine is unchanged at 2.4 mg/dL, and her serum [K+] is 5.3 meq/L, which
is similar to values she has had in the past.
15. A 22 year old female with history of Bipolar Affective Disorder is brought by ambulance
to the Emergency Department after swallowing a bottle of aspirin in a suicide attempt.
Her ABG is 7.38/23/84 on room air, HCO3- 16, anion gap = 18, albumin = 4.0.