Respiratory medicine: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Respiratory medicine

Sample item

Which arterial blood gas pattern is most consistent with acute hypercapnic respiratory failure?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Elevated carbon dioxide with acidemia

Acute ventilatory failure causes carbon dioxide retention, raising arterial carbon dioxide and lowering pH before substantial renal bicarbonate compensation can occur, often in severe COPD exacerbation or neuromuscular weakness.

Option by option

  • A. Low carbon dioxide with alkalemia

    Low CO2 with alkalemia indicates hyperventilation rather than hypoventilation.

  • B. Elevated carbon dioxide with acidemia (correct)

    Correct: acute CO2 retention produces respiratory acidosis.

  • C. Low lactate with severe alkalosis only

    Lactate reduction is not the diagnostic pattern for ventilatory failure.

  • D. Normal oxygen with isolated high bicarbonate

    High bicarbonate alone does not define acute hypercapnic failure.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Elevated carbon dioxide with acidemia. Acute ventilatory failure causes carbon dioxide retention, raising arterial carbon dioxide and lowering pH before substantial renal bicarbonate compensation can occur, often in severe COPD exacerbation or neuromuscular weakness.

Why is "Low carbon dioxide with alkalemia" not the answer?

Low CO2 with alkalemia indicates hyperventilation rather than hypoventilation.

Why is "Low lactate with severe alkalosis only" not the answer?

Lactate reduction is not the diagnostic pattern for ventilatory failure.

Why is "Normal oxygen with isolated high bicarbonate" not the answer?

High bicarbonate alone does not define acute hypercapnic failure.

What concept does this question test?

It tests Respiratory medicine in General Medicine. The correct option holds because: Correct: acute CO2 retention produces respiratory acidosis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Respiratory medicine?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.