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Retired NBME 15 Answers

nbme15/Block 3/Question#5 (reveal difficulty score)
A previously healthy 35-year-old woman ...
PO2 50, PCO2 80, (A-a)O2 10 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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Barbituate overdose causes CNS depression that can lead to hypoventilation. In Hypoventilation due to CNS depression, there is hypoxemia with a normal A-a gradient because the alveoli themselves are not injured and rather there is simply less oxygen overall reaching the alveoli due (FA2020 p669). A normal A-a gradient is around 10 mmHg (estimated as age/4+4, FA2020 p668). CO2 will also be increased because of retention of more "stale air" in the alveoli and lower respiration which allows less expiration of CO2.

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