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PHARM 557 > 04.04 Acid Base > Flashcards

04.04 Acid Base Flashcards

(52 cards)

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1
Q

T/F Acid-base disorders are disease states?

A

F

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2
Q

HCO3- Normal lab value

A

24-30 mEq/L

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3
Q

Normal Hydrogen ion concentration in the plasma is around?

A

40 nmol/L

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4
Q

There are several endogenous organic bases, what are two most common?

A
  1. HCO3-

2. LACTATE

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5
Q

Normal Arterial Blood pH

A

7.35-7.45

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6
Q

Arterial blood pH:

acidemia

A

<7.35

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7
Q

Arterial blood pH:

alkalemia

A

> 7.45

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8
Q

PaCO2 lungs normal value

A

35-45 mmHg

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9
Q

PaCO2 (mmHg):

Respiratory alkalosis value

A

<35 mmHg

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10
Q

PaCO2 (mmHg):

Respiratory acidosis value

A

> 45mmHg

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11
Q

TCO2(mEq/L):

Metabolic acidosis value

A

< or = 22 mEq/L

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12
Q

TCO2 (mEq/L):

Metabolic alkalosis value

A

> or = 26mEq/L

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13
Q

T/F-A patient can have concurrent respiratory acidosis and respiratory alkalosis

A

F

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14
Q

T/F- A patient cannot have concurrent metabolic acidosis and metabolic alkalosis

A

F

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15
Q

T/F- A patient may have concurrent metabolic and respiratory acid-base disorders

A

T

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16
Q

T/F-arterial pH value within the normal range (7.35-7.45) DOES NOT exclude the presence of acid-base disorders

A

T

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17
Q

PaO2 normal value

A

> 70

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18
Q

Anion Gap Value

A

??

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19
Q

Anion Gap Formula

A

Na-CL-HCO

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20
Q

An elevated PaCO2 is commonly seen with ____ ventilation, and _____ ventilation is associated with a LOW Pa CO2

A
  1. hypo

2. hyper

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21
Q

What is the normal range for the anion gap

22
Q

An elevated pH on ABGs and an elevated serum bicarbonate

concentration are hallmark signs of a _______

Study These Flashcards
A

metabolic alkalosis

23
Q

___is an example of a medication that can induce a metabolic acidosis by inhibiting carbonic anhydrase

Study These Flashcards
A

Acetazolamide

24
Q

Respiratory Acidosis, what is the compensation mechanism?

Study These Flashcards
A

Kidneys reabsorb HCO3 - [↑pH, ↑HCO3]

25
Metabolic Acidosis, what is the compensation mechanism?
Pulmonary Compensation: Hyperventilation releases CO2 [↑pH, ↓pCO2]
26
Respiratory Alkalosis, what is the compensation mechanism?
Renal Compensation: Kidneys excrete HCO3- [↓pH, ↓ HCO3-]
27
Metabolic Alkalosis, what is the compensation mechanism?
Pulmonary Compensation: Hypoventilation retaining CO2 [↓pH, ↑pCO2]
28
Adverse clinical effects associated with a metabolic acidosis include a decrease in cardiac output, ____tension,[increase/decrease] in release of calcium from the bone, and [increase/decrease] in protein catabolism
1. hypo 2. increase 3. increase
29
In the diagnosis | of metabolic acidosis, the calculation of an _________ is imperative to determine origin
anion gap
30
anion gap lab is used in what condition?
metabolic acidosis
31
Arteriolar constriction, reduction in coronary blood flow, hypokalemia, tetany, seizures, and delirium are adverse consequences seen with severe ______
alkalosis.
32
Saline-responsive metabolic alkalosis is [more/less] | common than saline resistant
more
33
Metabolic ALKALOSIS is divided into two categories based on what?
depending upon urine chloride levels
34
Metabolic ACIDOSIS is divided into two categories based on what?
anion gap levels
35
changes in potassium would be associated with what type of metabolic acidosis?
Non-Anion Gap
36
``` 29 Year old woman in the ED for migraine o pH of 7.52 o PaCO2 of 21 mmHg o Chem Panel: 142, 112, 10, 4.8, 21, 101 o Respiratory rate is 30-35 bpm (due to pain) ```
she has alkalemia | She has respiratory alkalosis, and looking at the bicarbonate concentrations (21), she has mild metabolic acidosis
37
Most common reason for increased respiratory rate, which leads to respiratory alkalosis:
Pain, nerves, white coat syndrome, drugs that stimulate respiration, intoxication
38
Most patients who are hyperchloremic will most likely have some sort of ? (what condition)
metabolic acidosis
39
metabolic alkalosis, secondary to dehydration what would you expect in the following levels? chloride CO2 BUN BUN to creatinine ratio
decreased high high high
40
Na value of 140, Cl of 110, and CO2 of 25 what is the anion gap?
140 - (110+25)= 5
41
MUDPILES, is an acronym for what?
high conditions/drugs/etc cause increased ion gap metabolic acidosis
42
increased ion gap metabolic acidosis _ _ _ PILES what high conditions/drugs/etc are the blanks?
-M stands for Methanol -U stands for Uremia o People who have uremia also have high BUN levels as well -D stands for Diabetic Ketoacidosis
43
increased ion gap metabolic acidosis MUD _ _ _ ES what high conditions/drugs/etc are the blanks?
-P stands for Paraldehyde (not used anymore) -I stands for Ingestion of organic solutions -L stands for Lactate o For someone who has sepsis, lactate will increase
44
increased ion gap metabolic acidosis MUDPIL _ _ what high conditions/drugs/etc are the blanks?
- E stands for Ethanol | - S stands for Salicylic Acid (aspirin)
45
Normal anion gap metabolic acidosis is also called _________ because the kidneys reabsorb ___ instead of reabsorbing HCO3−.
hyperchloremic acidosis Cl−
46
Tx for metabolic alkalosis?
nclude volume replacement, correction of potassium and magnesium deficits, and carbonic anhydrase inhibition with acetazolamide. Treatment of metabolic alkalosis associated with a primary mineralocorticoid excess includes the use of spironolactone.
47
A patient presenting with a respiratory acidosis will have a ___ pH and an ___ pCO2 on measurement of ABGs
low elevated
48
[hypo/hyper]ventilation is closely linked with respiratory acidosis.
hypo
49
The kidneys begin initiation of compensation within 6-12 hours and may require 3-5 days for complete compensation What condition?
respiratory acidosis
50
Anxiety, confusion, personality changes, hallucinations, motor disturbances, and dyspnea may be seen in _______
respiratory acidosis
51
Overdose of opioids or BZPs would most likely be seen in?
respiratory acidosis
52
Tx for resp acidosis?
Treatment may include antidotes such as flumazenil and naloxone if benzodiazepines or opioids, respectively, are implicated in the development of hypoventilation. Other treatments may include bronchodilators, steroids, antibiotics, and ventilator support. Alkali therapy should be avoided.

PHARM 557 (7 decks)

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