acid base balance

Question 1

people want to breath so when respiratory acidosis is seen should mechanical ventilation be used

Answer 1

no treat symptoms first the body wants to breath as soon as it can

Question 2

Respiratory alkalosis can be managed by doing what to ventilator

Answer 2

decreasing rate

Question 3

metabolic acidosis with significant hyperkalemia should be treated with

Answer 3

Treat underlying cause
fluide reuscitation
HCO3

Question 4

Patient wiht chronic renal failure with normal anion gap but metabolic acidosis is seen how to treat

Answer 4

treat with bicitra

Question 5

When managing patient with metablic alkalosis with very low hypokalemia how do you manage

Answer 5

correct volume deficit and give KCL
D/C diuretics
h2 blockers in patients iwth GI loss

Question 6

When managing patient with metablic alkalosis with contraindicated fluid replacement how do you manage

Answer 6

acetazolamide

Question 7

With respiratory acidosis how long will it take for the renal compensatory mechanism to take effect

Answer 7

6-12 hours renal compensation will be activated but take several days to correct

Question 8

respiratory acidosis results from decreased ventilation of

Answer 8

aveloli

Question 9

Patient comes in with c/o of sleepiness, and headache. Says he feels confused and out of it lately. you notice flapping and twitching in hands, respiration look labored you suspect what metabolic issue

Answer 9

RESPIRATORY ACIDOSIS

1) somnolence and confusion
2) myoclonus with asterixis
3) increase cerebral blood flow leading to incerased icp

Question 10

Patient comes in with c/o of sleepiness, and headache. Says he feels confused and out of it lately. you notice flapping and twitching in hands, respiration look labored you suspect what metabolic issue labs ph, pco2, hco3, and cl would look like

Answer 10

Respiratory acidosis 
ph less than 7.35
pco20 greater than 45
hco3 greater than 26
cl less than 93

Question 11

Patient comes in with c/o of sleepiness, and headache. Says he feels confused and out of it lately. you notice flapping and twitching in hands, respiration look labored you suspect what metabolic issue Management of would include

Answer 11

Respiratory acidosis
assess for narcotis, Narcan (if no obvious cause)
Improve ventilation (possibly intubations)
increased rate on ventilator, once on ventilator

Question 12

respiratory alkalosis causes clinical symptoms due to cerebral blood flow

Answer 12

decrease

Question 13

management of respiratory alkalosis starts with treating

Answer 13

the underlying cause

Question 14

if patient has respiratory alkalosis due to acute hyperventilation syndrome what would be done to manage

Answer 14

have patient breath into paper bag

Question 15

If patient is on a ventilator and becomes respiratory alkalosis what could be done to treat

Answer 15

decrease rate of ventilation

possible sedate

Question 16

Rapid correction of chronic alkalosis can lead to

Answer 16

metabolic acidosis

Question 17

Patient comes in with complaints of light headedness, anxiety, tingling and numbness in right arm. Respiration is very rapid, you suspect what ph issue

Answer 17

Respiratory alkalosis

Question 18

Patient comes in with complaints of light headedness, anxiety, tingling and numbness in right arm. Respiration is very rapid, you suspect what ph issue, labs for ph, pC02, Serum HCO3 look like

Answer 18

respiratory alkalosis
ph greater than 7.45
pco2 less than 35
hco3 greater than 26 if chronic issue

Question 19

Patient comes in with complaints of light headedness, anxiety, tingling and numbness in right arm. Respiration is very rapid, you suspect what ph issue, you treat with

Answer 19

Respiratroy alkalosis
treat underlying cause
May ask to breath into bag if acute hyperventilation syndrome

Question 20

Patient on ventilator with ph 7.55 pco2 28, what ph issue, you treat with

Answer 20

respiratory alkalosis
manage underlying cause
decrease vent rates
sedation may be necessary

Question 21

The hallmark sign of low serum HCO3 suggests

Answer 21

Metabolic acidosis

Question 22

Measurement of what gap lends to clues toward cause and treatments of metabolic acidosis; if increased this means

Answer 22

Anion Gap
=Na+K]-[hco3+cl)

Increased anion gap indicates acute incident

Question 23

DKA, Alcoholic KA, lactic acidosis, drug or chemical anion would be examples of what type ph issue? what type of gap?

Answer 23

metabolic acidosis with increase anion gap

Question 24

Diarrhea, Ileostomy, renal tubular acidosis, and recovery from DKA would be examples of what type ph issue? what type of gap?

Answer 24

metabolic acidosis with normal anion gap

Question 25

Patient with history DMtype 1 comes in with 600 blood sugar, ph of 7.2 you suspect, and treat with, what type of

Answer 25

metabolic acidosis

treat underlying disorder and give fluid

Question 26

Patient with hyperkalemia comes in with ph of 7.2 you suspect, and treat with, what type of gap would be seen

Answer 26

metabolic acidosis
would see normal GAP
treat with HCO3

Question 27

Patient with history of chronic renal failure, comes in with sob, labs show ph 7.2, what type of ph issues is this,

Answer 27

meatbolic acidosis

bicitra

Question 28

what ph issue is characterized by high plasma HCO3 and pco2 55mm

Answer 28

metabolic acidosis

Question 29

what is the most common cause of metabolic alkalosis and how is it treated

Answer 29

volume contraction saline responsive,
Correct volume of deficit with na and Kcl
DC diurectics
H2 blockers (if GI loss)

Question 30

Vomiting, diuretics, volume contraction, NG suction or post-hypercapnia would be seen in what ph issue

Answer 30

metabolic alcolosis

Question 31

what is the most common cause of metabolic alkalosis and how is it treated if patient has severe CHF and vomiting

Answer 31

volume contraction
treat metabolic acidosis with acetazolamide if fluid resusitation is contraindicated
decrease diuretic

Question 32

Hypokalemia with metabolic alkalosis should be treated how.

Answer 32

fluids and na and K+, discontinue diuretics

Question 33

what is the most common cause of metabolic alkalosis and how is it treated if patient has severe CHF and vomiting

Answer 33

volume contraction

Acetazolamide 250-500 iv q4-6 if volume replacement is contradicted

Question 34

Patient comes into clinic state vomiting for days, looks weak. During testing looks hyporeflexive. you suspect you treat how

Answer 34

Metabolic alkalosis with possible Hypokalemia

Treat with fluids replace K