Acid/Base Flashcards
What is the normal anion gap?
12-16*
if using K+
What are all the causes of metabolic acidosis with a high anion gap? (7)
- methanol
- uremia
- DKA, starvation
- Paraldehyde
- Lactic acidosis
- ETOH, Ethylene glycol
- Salicylates
What are all the causes of metabolic acidosis with a normal anion gap? (6)
- Diarrhea
- Iliostomy
- Ileal loop ureter
- renal tubular acidosis (RTA)
- adrenal insufficiency
- HCl admin
How can you use the plasma osmolality to identify if the patient is having metabolic acidosis d/t alcohol intoxication?
- calculated and measured osmolality will have a 20+ difference
What are all the causes of metabolic alkalosis with a low urine Cl (<10)? (3)
- Vomiting, NG tube
- Post-diuretic therapy
- Villous adenoma
What are all the causes of metabolic alkalosis with a high urine Cl (<20)? (2)
- Primary aldosteronism
- Cushing’s syndrome
How do you measure the anion gap?
(Na + K) - (Cl + HCO3) = anion gap
How do you measure plasma osmolality?
2(Na+K) + (BUN/2.8) + (Glu/18) = plasma Osm
In metabolic acidosis how do you check if the compensation of pCO2 was appropriate?
pCO2 should DECREASE between 1-1.4x the decrease in HCO3
In metabolic alkalosis how do you check if the compensation of pCO2 was appropriate?
pCO2 should INCREASE between 0.4-0.7x the increase in HCO3
How do you measure if respiratory ACIDOSIS is acute vs chronic?
- acute = H+ change is .75x pCO2 change
- chronic = H+ change is 0.3x pCO2 change
How do you measure if respiratory ALKALOSIS is acute vs chronic?
- acute = H+ change is .75x pCO2 change
- chronic - H+ change is 0.5x pCO2 change
