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Flashcards in Acid-Base Deck (11):
1

What are common causes of respiratory acidosis?

COPD, asthma, drugs (opioids, benzos, barbiturates, alcohol); chest wall problems (paralysis, pain); sleep apnea

2

What are common causes of metabolic acidosis?

gap = MUDPILERS
methanol
uremia
DKA
propylene glycol
iron poisoning/isoniazid
lactic acidosis
ethylene glycol
rhabdomyolysis
salicylates

non-gap: diarrhea, carbonic anhydrase inhibitors

3

What are the common causes of metabolic alkalosis?

respiratory: aspirin overdose (along with metabolic acidosis, tinnitus, hypoglycemia, vomiting); hyperventilatoin

metabolic: diuretics (except carbonic anhydrase inhibitors, vomiting, volume contraction, antacid abuse/milk alkali syndrome (overabundance of calcium), hyperaldosteronism

4

What are the different etiologies of hyponatremia?

hypovolemic: Dehydration, diuretics, hyperaldosteronism, Addison's disease

euvolemic: SIADH, psychogenic polydypsia, oxytocin use

hypervolemic: CHF, nephrotic syndrome, cirrhosis, renal failure

spurious: hyperglycemia (if sugar over 200, sodium decreases by 1.6 every 100 mg/dL of sugar), hyperproteinemia, hyperlipidemia can make sodium look low

5

What should be the rate of correction for hyponatremia?

Should not exceed 0.5-1 meq/L/h

6

What causes hyperkalemia?

1) kidney failure
2) tissue lysis
3) hypoaldosteronism (in diabetes, can have hyporeninemic hypoaldosteronism)
4) medications (K sparing diuretics, ACEis)
5) adrenal insufficiency

7

What are signs/symptoms of hypocalcemia?

Chvostek's sign (spasm with tap facial nerve); Trousseau's sign (carpal spasm with inflation of BP cuff); prolongation of QT

depression, seizures, encephalopathy

8

What causes hypocalcemia?

hypoparathyroidism (post-thyroidectomy (if parathyroid's removed); renal failure, acute pancreatitis; vit D deficiency; etc

9

Hypocalcemia can also be caused by (acidosis/alkalosis)

alkalosis. Alkalosis causes calcium to shift intercellularly. This is why when people hyperventilate, they get perioral numbness.

10

What are the signs of hypercalcemia?

Bones, groans, stones, psychiatric overtones

bones: osteopenia, pathologic fractures
groans: abdominal pain, anorexia, constipation, n/v
stones: kidney stones, polyuria
psychiatric: delirium, depression, psychosis

QT interval shortening

11

What fluids do you give to an adult not eating?

1/2 NS with 5% dextrose and 10-20 mEq of K/L of fluid to prevent hypokalemia