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Clinical Pathology > Acid-Base and Electrolytes > Flashcards

Acid-Base and Electrolytes Flashcards

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1
Q

Most sodium is found in the _______ space

A

Extracellular (ECF - interstitial and intravascular spaces)

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2
Q

Most potassium is found in the _______ space

A

Intracellular (ICF)

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3
Q

What is the movement of K+ into cells from the ECF largely dependent on?

A

Insulin and catecholamines (they stimulate potassium uptake into cells)

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4
Q

What is a pseudohyperkalemia? What are two common causes of this?

A

Falsely elevated potassium levels due to:
- Sample hemolysis (release of K+ from platelets during clotting)
- Breed-related change (Japanese breeds)

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5
Q

Which breeds commonly show a pseudohyperkalemia?

A

Horses, cattle, and Japanese dog breeds (Akitas, Shiba Inus)

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6
Q

What are the three mechanisms behind hyperkalemia?

A
  1. Decreased renal excretion (Addison’s, urinary obstruction, renal failure)
  2. Increased total body potassium (iatrogenic administration of potassium)
  3. Shifting of potassium from ICF to ECF (no change in total body potassium)
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7
Q

What is the most common mechanism of true hyperkalemia?

A

Reduced renal excretion (Addison’s, urinary obstruction, renal failure)

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8
Q

What is the mechanism behind hypokalemia?

A
  1. Decreased total body potassium (anorexia, diuretics)
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9
Q

Hypernatremic or hypertonic dehydration is primarily due to the loss of _________

A

Water (H2O loss > Na loss)

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10
Q

Hyponatremic or hypotonic dehydration is primarily due to the loss of ________

A

Electrolytes (H2O loss < Na loss)

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11
Q

What are the two mechanisms behind hypernatremia?

A
  1. Decreased total body water (ex. decreased consumption or increased loss)
  2. Increased total body sodium (iatrogenic administration of hypertonic fluids, excessive consumption of salt)
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12
Q

What are the three mechanisms behind hyponatremia?

A
  1. Excessive sodium loss with continued water intake (GI and renal loss)
  2. Increased total body water (edema)
  3. Shifting of water from the ICF to ECF (ex. due to hyperglycemia)
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13
Q

What is the most common mechanism of hyponatremia?

A

Excessive loss with continued water intake (ex. vomiting, pleural/peritoneal effusion, Addison’s, PUPD)

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14
Q

Hypernatremia will cause water to shift out of the __________ and into the _________

A

ICF, ECF (due to high Na in blood, water gets sucked out of the cells and goes into the blood) = cell shrinking

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15
Q

Hyponatremia will cause water to shift out of the _________ and into the _________

A

ECF, ICF (due to low Na in blood, water gets sucked out of the blood and goes into the cell) = cell swelling

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16
Q

Chloride is normally proportionate to _________ levels and inversely proportional to __________ levels

A

Sodium, HCO3- (bicarbonate)

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17
Q

What are the two mechanisms behind hyperchloremia?

A
  1. Increased GI loss of HCO3- (increases Cl-)
  2. Increased renal loss of HCO3- (increases Cl-)
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18
Q

What are the two mechanisms behind hypochloremia?

A
  1. Loss or sequestration of HCl (HCO3- will increase to maintain neutrality, therefore Cl- decreases)
  2. Excessive loss with continued water intake
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19
Q

What are three main causes of hypochloremia?

A

Vomiting, displaced abomasum, or GI obstruction

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20
Q

What is hyperchloremic metabolic acidosis?

A

A loss in blood HCO3 and elevation in Cl- with a normal anion gap

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21
Q

What is pseudeohyperchloremia?

A

Falsely elevated chlorine levels associated with administration of potassium bromide (machine cannot tell the difference between chloride and bromide)

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22
Q

What is hypochloremic metabolic alkalosis?

A

A loss or sequestration of HCl, which raises blood pH

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23
Q

Which organs are the principle regulators of acid-base balance?

Study These Flashcards
A

Kidneys and lungs

24
Q

Which organ acts as a faster regulator of acid base balance?

Study These Flashcards
A

The lungs (the kidneys take way longer - like 5 days)

25
What respiratory acid do the lungs normally excrete?
Carbon dioxide
26
Describe how the lungs can regulate acid base balance
Lungs excrete CO2 as a respiratory acid, therefore the amount expired can be regulated and affect acid base status
27
How will hyperventilation affect acid base balance?
Faster breathing → faster expiration of CO2 → decreased amount of CO2 in blood → alkalosis
28
How will hypoventilation affect acid base balance?
Slower breathing → retention of more CO2 → increased amount of CO2 in blood → acidosis
29
In respiratory acidosis, breathing will be ________
Slow
30
In respiratory alkalosis, breathing will be ________
Fast
31
What are two ways that the kidneys regulate acid base balance?
1. Excretion of H+ 2. Conservation or generation of HCO3- (reabsorb HCO3- or convert CO2 to H+ and HCO3-)
32
Name the four primary acid base disturbances
1. Respiratory acidosis 2. Respiratory alkalosis 3. Metabolic acidosis 4. Metabolic alkalosis
33
A respiratory acid base disturbance causes changes in _________
PCO2
34
A metabolic acid base disturbance causes changes in _________
HCO3-
35
What are three causes of respiratory acidosis?
*Breathing slow* - Pulmonary disease (asthma, pneumonia) - Anesthesia - CNS or respiratory depressant drugs
36
What is the compensation for respiratory acidosis?
Metabolic alkalosis (kidneys excrete H+ into urine in exchange for Cl- and HCO3- conservation)
37
What are four causes of respiratory alkalosis?
*Breathing fast* - Pain - Stress/anxiety - Extreme exercise - Overheating
38
What is the compensation for respiratory alkalosis?
Metabolic acidosis (kidney increases secretion of HCO3- in exchange for Cl- to maintain blood neutrality and retain H+)
39
What are the two types of metabolic acidosis?
*More acidic than basic, but why?* 1. Gain of H+/acids (high anion gap acidosis/normochloremic acidosis) 2. Loss of HCO3- (normal anion gap acidosis/hyperchloremic acidosis)
40
How can you differentiate between the two types of metabolic acidosis?
Anion gap
41
What is the anion gap?
When total cations do not equal total anions (Na + K + unmeasured cations) ≠ Cl- + HCO3- + unmeasured anions **Unmeasured anions include anions of organic acids**
42
What is the rearranged formula for anion gap?
Anion gap = (Na + K) - (Cl- + HCO3-)
43
What is a high anion gap acidosis?
Gain of H+
44
What are the four main differentials for a high anion gap acidosis?
Lactic acid Uremic Ketones Exogenous substance (ethylene glycol) "LUKE" You can have more than one of these going on at the same time
45
What is another name for high anion gap acidosis?
Normochloremic acidosis
46
What is a normal anion gap acidosis?
A decreased HCO3- with concurrent hyperchloremia
47
What is another name for normal anion gap acidosis?
Hyperchloremic acidosis
48
What are the two main causes for a normal anion gap acidosis?
- GI HCO3- loss (diarrhea and esophageal obstruction in cattle) - Renal HCO3- loss
49
What are the two types of metabolic alkalosis?
*More basic than acidic, but why?* 1. Loss of H+/acids (results in disproportionate hypochloremia) 2. Gain of HCO3-
50
What is a main cause of metabolic alkalosis?
Loss of gastric acid (vomiting or sequestration with a GI block)
51
If blood pH is low and pCO2 is high, what is the primary acid base disturbance?
Respiratory acidosis
52
If blood pH is low and HCO3- is low, what is the primary acid base disturbance?
Metabolic acidosis
53
If blood pH is high and pCO2 is low, what is the primary acid base disturbance?
Respiratory alkalosis
54
If blood pH is high and HCO3- is high, what is the primary acid base disturbance?
Metabolic alkalosis
55
If there is a metabolic acidosis with an increased anion gap present, what is the cause?
Gain of acid/H+ (think of LUKE)
56
If there is a metabolic acidosis with a normal anion gap present, what is the cause?
Loss of HCO3-

Clinical Pathology (12 decks)

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