Chronic Lung Conditions and Acid-Base balance, any explanation please !?

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Hi Guys, I am new in here .. I found many interesting explanations on ur site that's why I decided to join ,I hope I can add good things to the forums.

I'm just having a vague issue concerning this question in a book called(STEP2 Secrets, Page 17, Q#6)

What happens to the blood gas of patients with chronic lung conditions?

In certain people with chronic lung conditions (especially those with sleep apnea), pH may be alkaline during the day because they breathe better when awake. In addition, just after an episode of bronchitis or other respiratory disorder, the metabolic alkalosis that usually compensates for respiratory acidosis is no longer a compensatory mechanism and becomes the primary disturbance (elevated pH and bicarbonate).As a side note, remember that sleep apnea, like other chronic lung diseases, can cause right-sided heart failure (cor pulmonale).


I Couldn't understand what is going on !! How the Metabolic Alkalosis becomes the primary disturbance !? what happened ?!

Thanx in advance
 
I'm gonna take a stab at this and say this. Metabolic alkalosis compensation takes time. Respiratory acidosis, on the other hand, manifests in a short period of time. Once you remove the offending process (i.e. bronchitis) you are not hypoventilating anymore and your pCO2 levels come down and you're out of respiratory acidosis. However, the kidneys take time (i think few days) to adjust that is why the metabolic alkalosis persists and is now classified as primary disturbance.
 
I'm gonna take a stab at this and say this. Metabolic alkalosis compensation takes time. Respiratory acidosis, on the other hand, manifests in a short period of time. Once you remove the offending process (i.e. bronchitis) you are not hypoventilating anymore and your pCO2 levels come down and you're out of respiratory acidosis. However, the kidneys take time (i think few days) to adjust that is why the metabolic alkalosis persists and is now classified as primary disturbance.
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