What manifestation(s) occur when a person has diabetes insipidus? (Select all that apply)

Choice A reason: Prolonged nasogastric suctioning removes gastric acid (HCl), reducing hydrogen ions in the blood, leading to metabolic alkalosis. This is reflected by elevated pH (7.50) and increased HCO3 (28 mEq/L), with normal PaCO2 as the lungs have not yet compensated. This matches the expected acid-base imbalance, making it correct.

Choice B reason: This result shows a slightly acidic pH (7.34) with normal PaCO2 and low HCO3, suggesting metabolic acidosis. Nasogastric suctioning causes loss of acid, not base, so it does not lead to acidosis. This imbalance is inconsistent with the alkalosis expected from gastric acid loss, making it incorrect.

Choice C reason: This result indicates a low pH (7.32) and elevated PaCO2, suggesting respiratory acidosis with partial compensation (normal HCO3). Nasogastric suctioning affects gastric acid, causing metabolic, not respiratory, alkalosis. The respiratory parameters here do not align with the condition’s pathophysiology, making this choice incorrect.

Choice D reason: This result shows an elevated pH (7.46) and low PaCO2, indicating respiratory alkalosis, likely from hyperventilation, with normal HCO3. Nasogastric suctioning causes metabolic alkalosis due to acid loss, not respiratory changes. The low PaCO2 does not fit the expected metabolic profile, making this choice incorrect.

Choice A reason: Air trapping in COPD, due to alveolar destruction and loss of elasticity, causes lung overinflation, increasing the anteroposterior chest diameter, resulting in a barrel chest. This is a direct consequence, making this the correct choice.

Choice B reason: Cyanosis occurs in COPD from hypoxia due to impaired gas exchange, not directly from air trapping. While common in advanced disease, it is not the primary manifestation of overinflation, making this incorrect.

Choice C reason: Clubbed fingers result from chronic hypoxia in COPD, not directly from air trapping. They develop over time due to tissue remodeling, not lung overinflation, making this choice incorrect.

Choice D reason: Lack of appetite is a systemic symptom in advanced COPD due to energy expenditure or hypoxia, not a direct result of air trapping or lung overinflation, making this choice incorrect.