Verklaar de hoogte van het Bicarbonaat-gehalte

The patient is a 60 yo veteran who comes in for increasing dyspnea. He carries a diagnosis of obstructive sleep apnea, has CPAP prescribed but does not take it. A recent echocardiogram showed normal left ventricular function. Previous pulmonary function studies showed no obstructive or restrictive lung disease. Physical exam revealed a markedly obese white male in no apparent distress. HEENT was remarkable for a hypertrophied soft palate and uvula. Heart sounds were distant. Lungs were clear without wheezing. He had no use of accessory muscles of respiration. Abdomen was huge without abnormalities. Extremities showed 3+ peripheral edema in his legs. Sodium 142, potassium 4.2, chloride 97, bicarb 35, BUN 14, creatinine 1.2 BNP at admission was 45. So the instinct question: Explain his bicarbonate of 35.
[tag: casus]

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