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MRCP Part 1

ABG & Acid–Base Decisions Lab

Interpret the gas, prove the compensation and act on the immediate threat.

Content check & educational use

Content check recorded. Fictional educational cases. Independent Clinora teaching, not an official MRCP examination, diagnostic tool or substitute for local emergency pathways.

0/1 attempted · 0 correct

Progress is stored for this visit only · not a pass prediction

Ventilatory failure

Persistent acidotic COPD exacerbation

ABG-01

A 72-year-old with severe COPD is drowsy but rousable after controlled oxygen, nebulised bronchodilators, corticosteroid and antibiotics. Respiratory rate is 30/min. The ABG is repeated 45 minutes after initial treatment.

Arterial · Venturi 28%

pH7.25PaCO₂9.2 kPaPaO₂7.4 kPaHCO₃⁻30 mmol/LBase excess3Lactate1.4 mmol/L
Reveal paired chemistry
Na⁺139K⁺4.7Cl⁻101Glucose8.1

Interactive acid–base map

Move CO₂ or bicarbonate to test the balance

Estimated pH7.25Henderson–Hasselbalch teaching estimate

Case position: The high bicarbonate signals chronic renal compensation, but the marked acidaemia shows an acute CO₂ rise on top.

Stepwise calculation

Show one inference at a time

What is the best next step?