Acid base abnormalities Flashcards

1
Q

diff betwen acidosis and acidemia

A

osis is the processes that tend to change ph in a given direction
emia is the resultant pH of the blood

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2
Q

acedemia pH

A

<7.4

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3
Q

alkalemia pH

A

> 7.4

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4
Q

sites of acid base regulation

A

chemical buffers
lung
kidney

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5
Q

metabolic acidosis

A

serum bicarbonate <24meq/L

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6
Q

metabolic alkalosis

A

serum bicarb >24meq/L

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7
Q

normal sodium bicarb

A

18-24 meq/L

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8
Q

respiratory acidosis

A

pco2 >40mmhg

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9
Q

respiratory alkalosis

A

pco2 <40mmhg

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10
Q

normal pCO2

A

35-40mmghg

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11
Q

major chemical buffer

A

pH dependent on relative ratio between carbon dioxide(acid) and bicarbonate (base)
if altered get an acid base abnormality

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12
Q

respiratory regulation of co2 elimination

A

medullary chemoreceptors in the respiratory center are activated by cerebral arterial CO2
lungs compensate for metabolic disturbances

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13
Q

increasing the rate and depth of respiration increases ….

A

quantity of CO2 to be eliminated by lungs

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14
Q

renal regulation of H/HCO3

A

kidneys reabsorb filtered bicarbonate and eliminate H

takes much longer - in resp acidosis

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15
Q

in presence of resp acidosis the kidneys..

A

excrete hydrogen ions and conserve bicarbonate ions

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16
Q

in presence of resp and metabolic alkalosis kidneys..

A

retain H and excrete bicarb

17
Q

resp alkalosis compensation

A

every 10mmhg decrease in co2, hco3 decrease by 2mmole

18
Q

resp acidosis compensation

A

every 10mmhg increase in pco2, hco3 increase by 1mmole

19
Q

metabolic alkalosis compensation

A

every mmole increase in hco3, pco2 increase 0.7mmhg

20
Q

metabolic acidosis compensation

A

every decrease in hco3, pco2 decrease by 1mmhg

21
Q

in acid base disorder if the expected compensatory response hasnt occurred what does that indicate

A

mixed acid base disturbance

22
Q

what is an anion gap

A

difference in cations and anions
AG = unmeasured anions - unmeasured cations
…… i think this is backwards…..

23
Q

why is K not included in anion gap calculation

A

largely an intracellular cation that rarely alters the gap

24
Q

anion gap formula

A

AG = (Na) - (Cl + HCO3)

25
what is the normal anion gap
12 +/- 4 mEq/L
26
what does a high anion gap mean
increased unmeasured anions or decreased unmeasured cations
27
what is high anion gap metabolic acidosis
generation of acid that titrates the bicarbonate with an unmeasured anion chloride concentraion remains normal (normochloremic acidosis)
28
what is normal anion gap metabolic acidosis
processes that cause bicarbonate loss and chloride retention chloride concentraion higher (hyperchloremic acidosis)
29
causes of high anion gap metabolic acidosis
renal failure lactic acidosis ketoacidosis drugs and toxins
30
causes of normal anion gap metabolic acidosis
``` acetazolamide acidifying agents cholestyramine GI bicarbonate loss (diarrhea) chloride retention (renal acidosis) ```