Acid/Base Disorders

Question 1

Metabolic disorder

Answer 1

disorder caused primarily through alterations in bicarbonate

Question 2

Respiratory disorder

Answer 2

disorder caused primarily through alterations in carbon dioxide

Question 3

What are the responsible parties in metabolic disorders; respiratory

Answer 3

kidneys; lungs

Question 4

hyperventilation causes what change in pH

Answer 4

increase/ alkalosis: more loss of carbon dioxide (the acid portion)

Question 5

What is the acid compound; base compound

Answer 5

PaCO2; HCO3

Question 6

In respiratory compensation how does it occur, how many phases are there and how quickly is it

Answer 6

changes in breathing, one phase, minutes to hours

Question 7

In metabolic compensation how many phases, what are they, are there, how long are the phases

Answer 7

two phases: acute and chronic, 24 hours and 72 hours. There can be a period where this no compensation before 24 hours.

Question 8

What are the three most important aterial blood gas components and serum chemistry panel, what are the normal values

Answer 8

pH,PaCO2,HCO3; 7.4, 40, 24

Question 9

High PaCO2 causes

Answer 9

Respiratory acidosis

Question 10

Low PaCO2 causes

Answer 10

Respiratory alkalosis

Question 11

High HCO3 causes

Answer 11

Metabolic alkalosis

Question 12

Low HCO3 causes

Answer 12

Metabolic acidosis

Question 13

Causes of metabolic acidosis

Answer 13

Excess acid production, loss of bicarbonate base,diminished renal acid secretion,renal loss of bicarbonate base

Question 14

What causes excess acid production Hint(Mudpiles) also known as high anion gap metabolic acidosis

Answer 14

Methanol, uremia, diabetic ketoacidosis, paraldehyde/propylene glycol, isoniazid, lactic acidosis, ethylene glycol, salicylates

Question 15

What does winter’s formula give

Answer 15

What the PaCO2 value should be if there is compensation present

Question 16

If winter’s formula is used and the measured PCO2 is higher than the predicted value what does this mean

Answer 16

Concurrent respiratory acidosis

Question 17

If Winter’s formula is used the measured PCO2 is lower than the predicated value what does this mean

Answer 17

Concurrent respiratory alkalosis

Question 18

Causes of respiratory acidosis

Answer 18

The patient cannot breathe or will not breathe, increased dead space (alveolar deadspace)

Question 19

In acute metabolic compensation for respiratory acidosis what should be the predicted values

Answer 19

for every increase by 10 of PCO2 there should be +1 HCO3

Question 20

In chronic metabolic compensation for respiratory acidosis what should be the predicted values

Answer 20

for every increase by 10 of PCO2 there should be +3 HCO3

Question 21

If the measured HCO3 is lower than predicted in metabolic compensation what does this mean

Answer 21

There is concurrent metabolic acidosis OR no compensation

Question 22

If the measured HCO3 is higher than predicted in metabolic compensation what does this mean

Answer 22

There is concurrent metabolic alkalosis

Question 23

What causes Metabolic alkalois

Answer 23

Hydrogen ion loss, Excessive retention of HCO3, loss of volume contraction around a relatively stable amount of HCO3

Question 24

In respiratory compensation for metabolic alkalosis what does it mean if the PaCO2 is less than predicted, more than predicted

Answer 24

concurrent respiratory alkalosis, concurrent respiratory acidosis

Question 25

What cause respiratory alkalosis

Answer 25

anxiety, pain, high altitudes, intoxications

Question 26

In the acute phase for metabolic compensation of respiratory alkalosis what should the value be

Answer 26

For every decrease by 10 of PaCO2 there should be a decrease of HCO3 by -2

Question 27

In the chronic phase for metabolic compensation of respiratory alkalosis what should the value be

Answer 27

For every decrease by 10 of PaCO2 there should be a decrease of HCO3 by -4

Question 28

In metabolic compensation for respiratory alkalosis what does it mean if the measured value HCO3 is less than expected

Answer 28

concurrent metabolic acidosis

Question 29

in metabolic compensation for respiratory alkalosis what does it mean if the measured value HCO3 is more than expected

Answer 29

concurrent metabolic alkalosis OR not yet compensated

Question 30

What is the 5 step approach to figuring out acid-base disorders

Answer 30

1) Check the contributors
2) Check to see the type of emia
3) Check to see if the blame is respiratory
4) See if there is a metabolic component
5) Check to see if there is compensation

Question 31

Delta Ratio meanings

Answer 31

If the Delta ratio= 1 the change in anion gap is due to HCO3, if the delta ratio is greater than 1.6 there is concurrent metabolic alkalosis. if the delta ratio is less than .8 there is concurrent non-anion gap metabolic acidosis