Acid/ Base Disturbance

Question 1

List the conditions that can lead to NAGMA?

Answer 1

HARDUP
H: hyperchloremia (parenteral nutrition) (normal saline infusion associated)
A: acetazolamid
R: RTA
D: Diarrhea
U: Ureteral diversion
P: Pancreatic fistula

Question 2

What is the cause of non-anion gap metabolic acidosis?

Answer 2

loss of bicarbonate

Question 3

List the conditions that can lead to anion gap metabolic acidosis.

Answer 3

MUDPILES
M: methanol
U: uremia
D: diabetic ketoacidosis
P: paraldehyde
I: iron; isoniazid
L: lactic acidosis
E: ethylene glycol; ethanol ketoacidosis
S: salicylates; starvation

Question 4

What is the action of PGs (main action) on arterioles of kidney?

Answer 4

PGs vasodilation of afferent arterioles

Question 5

What is the main action of Ang II on action at the arterioles of the kidney?

Answer 5

Ang II constricts the efferent arterioles

Question 6

What is the normal anion gap?

Answer 6

12 +/- 2

Question 7

How do you calculate anion gap?

Answer 7

Na+ - (Cl + HCO-3)

Question 8

Most dilute segment of the kidney?

Answer 8

DCT

Question 9

Causes leading to metabolic alkalosis?

Answer 9

• nasogastric suctioning or severe vomiting
• diuretic overuse
• primary hyperaldosteronism

Question 10

Causes of respiratory acidosis?

Answer 10

( hypoventilation)
* central respiratory depression (eg. opioid overdose)
* OHS, neuromuscular weakness
* chronic obstructive pulmonary disease

Question 11

Causes of respiratory alkalosis?

Answer 11

hyperventilation

• acute V/Q mismatch (eg, PE, pneumonia)
• anxiety
• inadequate pain control
• high altitude, pregnancy