In the presence of severe dehydration, what acid-base disorder reflects a pH of 8.2 and HCO3- of 33 mEq/L?

In the context of severe dehydration, a pH of 8.2 indicates alkalosis, as it is higher than the normal blood pH range of approximately 7.35 to 7.45. The bicarbonate level of 33 mEq/L is also elevated, as normal bicarbonate levels range from about 22 to 26 mEq/L.

When there is an increase in bicarbonate levels along with a high pH, this points towards metabolic alkalosis. Metabolic alkalosis typically occurs due to a loss of hydrogen ions or an increase in bicarbonate ions, which can often be seen in cases of severe dehydration where the body may compensate by retaining bicarbonates or losing acids through mechanisms such as vomiting or diuretic use.

In this scenario, neither respiratory acidosis nor respiratory alkalosis would explain a high pH and elevated bicarbonate. Respiratory acidosis would present with a low pH and high carbon dioxide, while respiratory alkalosis typically involves a high pH but is characterized by low carbon dioxide levels. Therefore, the combination of high pH and high bicarbonate unequivocally indicates metabolic alkalosis as the correct acid-base disorder in this situation.