Acid Base

Question 1

Winters Formula for what? formula?

Answer 1

expected PCO2 in metabolic acidosis/1.5(Hco3) + 8+/-2

Question 2

correct of AGAP for albumin?

Answer 2

every decrease in 1 of albumin (normal being 4), AGAP increases by 2

Question 3

Delta GAP=

Answer 3

AG-12

Question 4

Delta GAP + Serum hco3=

Answer 4

starting bicarb

Question 5

starting bicarb range?

Answer 5

<22- >26, either additional non gap acidosis or additional metabolic alkalosis

Question 6

AGAP causes?

Answer 6

methanol, propylene glycol, ethylene glycol, Pyroglutamic acid(tylenol), isoniazid

Question 7

Type B lactic acidosis causes?

Answer 7

Linezolid, Propofol, Metformin

Question 8

toxic alcohol that does not cause AGAP?

Answer 8

isopropyl alcohol

Question 9

fomepizole MOA?

Answer 9

inhibits lactate dehydrogenase

Question 10

3 causes of normal anion gap acidosis?

Answer 10

RTA, GI loss, ileal conduit

Question 11

Urine anion GAP=

Answer 11

(Na+K)-Cl

Question 12

negative Ugap, high Ucl=

Answer 12

GI tract loss

Question 13

positive Ugap, low Ucl=

Answer 13

renal dysfunction(RTA)

Question 14

Type 1 RTA location? normal mechanism distal tubule?

Answer 14

distal/normally excretes H+

Question 15

Type 1 RTA urine pH?

Answer 15

> 5.5

Question 16

Type 1 RTA potassium?

Answer 16

hypokalemia

Question 17

other signs of RTA type 1?

Answer 17

stones, high urine pH, hypokalemia

Question 18

Type 1 RTA treatment?

Answer 18

bicarbonate

Question 19

Type II RTA location? mechanism?

Answer 19

PCT/cannot reabsorb Hco3

Question 20

Type II RTA potassium?

Answer 20

hypokalemia like Type 1(secondary hyperaldosteronism)

Question 21

Type II urine pH?

Answer 21

<5.5 bc the distal tubule is working and acidifying urine

Question 22

Type II RTA treatment?

Answer 22

no point in giving bicarb because it wont be reasborbed. give diuretics to induce a contraction alkalosis

Question 23

Type 1 RTA causes?

Answer 23

Sjogrens, SLE, hashimoto, ampho B, nephrocalcinosis

Question 24

Type IV RTA mechanism?

Answer 24

Hypoaldosteronism

Question 25

Type IV RTA potassium?

Answer 25

hyperkalemia (only one)

Question 26

Type IV RTA causes?

Answer 26

DM, HIV, sickle cell

Question 27

ileal conduit treatment?

Answer 27

bicarbonate

Question 28

Metabolic alkalosis with high BP, high urine Na and Cl?

Answer 28

Conns syndrome

Question 29

Met alk with normal 3rd space, low urine chloride?

Answer 29

Saline responsive- vomiting, NGT,

Question 30

Met alk with normal 3rd space, high urine Cl?

Answer 30

Low K, low mag, Bartter, Gitelman

Question 31

Gitelman syndrome age? electrolytes?

Answer 31

hypomag, hypoK, older age

Question 32

Bartter syndrome different from Gitelman?

Answer 32

younger age with failure to thrive

Question 33

calculated osmolarity

Answer 33

2Na+BUN/2.8+ gluc/18

Question 34

causes of negative anion gap?

Answer 34

lithium and paraproteins

Question 35

5 oxoproline is what and can cause what?

Answer 35

pyroglutamic acid seen in tylenol use, can cause a high AGAP acidosis

Question 36

OTC deficiency, what is it? what are consequences? tx?

Answer 36

urea cycle disorder/ hyperammonemia/ lactulose and rifaximin and sodium benzoate

Question 37

tox alcohol that does not cause acidosis?

Answer 37

isopropyl alcohol

Question 38

why do aloholics get a AGAP acidois?

Answer 38

ketone body producting from starvation and increased lipolysis

Question 39

winters formula? expected PCO2 in metabolic acidosis

Answer 39

1.5x bicarb +8 +-2

Question 40

how does acteaminophen OD cause AGAP acidosis?

Answer 40

buildup of 5 oxoproline, and the treatment is NAC

Question 41

how do diuretics cause alkalosis?

Answer 41

secretion of hydrogen ions by the H/K ATPase pump

Question 42

how do loop diuretics work?

Answer 42

blocking the Na/K/CL co transporters in the thick ascending limb

Question 43

how does diuril work?

Answer 43

inhibitis NaCl absorption n the distal tubules

Question 44

difference between alcholic ketoacidosis and DKA?

Answer 44

Gluc<250 alcohol | very high ketones and high BHB in dka