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Year 2 Met > acid base balance > Flashcards

acid base balance Flashcards

1
Q

long term acidosis can lead to which organ failure?

A

kidney failure

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2
Q

acute acidosis problem ion

A

hyperkalemia

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3
Q

ingested acid eg aa’s is called

A

titrable acid

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4
Q

methanol poisoning which acid do you get

A

formic acid

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5
Q

CO poisoning

A

lactic acidosis

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6
Q

hypotension/hypoxia

A

impaired aerobic respiration ->anaerobic -> lactic acidosis

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7
Q

diabetes or starvation

A

beta hydroxybutarate or acetoacetate

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8
Q

what do strong acids do in water

A

completely dissociated

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9
Q

desire to breathe is goverened by

A

pCO2 and low pH

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10
Q

breathing off C02 does not regenerate…

A

bicarbonate buffer

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11
Q

vast majority of bicarb is reabsorbed at

A

proximal tubule

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12
Q

ammonium is made from

A

glutamine -> glutamate-> alpha ketoglutarate picks up protons

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13
Q

2 buffers in urine/kidneys

A

ammonium and phosphate (from diet)

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14
Q

resp acidosis/alkalosis primarily prob with which gas

A

CO2

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15
Q

met acidosis primary prob

A

low bicarb

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16
Q

high anion gap

A

added acid eg meths

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17
Q

normal anion gap

A

loss of bicarb

18
Q

what electrolytes normally measured

A

K+, Na+, HCO3-, Cl-

19
Q

how to calculate anion gap

A

K and Na - Bicarb and Cl

20
Q

normal anion gap

A

normally diarrhoea - loss of bicarb

21
Q

high anion gap

A

added acid

22
Q

metabolic acidosis

A

H

23
Q

when arterial blood gas

A

resp distress

24
Q

ABE

A

how much base needs to be added to get pH to normal

25
Q

abg artery

A

radial

26
Q

hyperventilation

A

alkalosis, low CO2
!!!O2 should be normal

27
Q

target sats in copd

A

88-92

28
Q

asthmatic becomes acidotic

A

very worrying - they’re gettin tired

29
Q

resp acidosis (3)

A

reduced ventilation drive
tired asthmatic
opiates
neuromusc or chest wall disease - kyphoscoliosed

30
Q

why calculate anion gap

A

decide whether loss of bicarb or added acid

31
Q

what is normal anion gap

A

12-16 mmol/l

32
Q

young pt met acidosis high anion gap

A

think DKA

33
Q

raised lactate

A

tissue hypoxia/poor perfusion
altered cellular resp
e.g. ischaemic bowel or diabetic foot about to drop off

34
Q

moribund

A

grey, deathly

35
Q

high potassium in acidosis

A

renal failure

36
Q

metabolic acidosis -»»>

A

CALCULATE ANION GAP

37
Q

why is anion gap normal in bicarb diarrhoea

A

CL-rises to rectify electrical neutrality

38
Q

what is renal tubular acidosis

A

1) distal - can’t get rid of H+
2) proximal can’t resorb bicarb
4) hyperkalemic - diabetics

39
Q

consequences of acidosis

acute (4)
chronic (3)

A
40
Q

why kidney stones in acidotic

A

calciuria bone resorption

41
Q

long term steroid can indiuce

A

hyperaldosteronism - H+ is lost

Year 2 Met (17 decks)

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