acid base disorders

Question 1

normal arterial pH

Answer 1

7.4

Question 2

normal plasma HCO3

Answer 2

24

Question 3

normal arterial pCO2

Answer 3

40

Question 4

normal plasma H+

Answer 4

36-44

Question 5

when HCO3 is lost, pH will…

Answer 5

decrease

Question 6

when pCO2 is lost, pH will…

Answer 6

increase

Question 7

when H+ is lost, pH will…

Answer 7

increase

Question 8

when pCO2 is gained pH will…

Answer 8

decrease

Question 9

the lungs manage ___ and ___

Answer 9

PCO2 and pH

Question 10

the kidneys manage ___ and ___

Answer 10

pH and HCO3

Question 11

in metabolic acidosis, pH goes ____ and HCO3 goes ___

Answer 11

down

down

Question 12

how are acid-base disorders diagnosed?

Answer 12

arterial blood gas interpretation

Question 13

what is the mechanism behind metabolic acidosis?

Answer 13

either gaining an acid (H+) or losing HCO3

Question 14

causes of anion-gap metabolic acidosis

Answer 14

lactic acidosis
ketoacidosis
renal insufficiency
aspirin

Question 15

causes of non-anion gap metabolic acidosis

Answer 15

renal tubular acidosis
GI loss of HCO3 (diarrhea)
excess saline infusion

Question 16

metabolic alkalosis mechanism

Answer 16

direct gain of HCO3, loss of H+

Question 17

causes of metabolic alkalosis

Answer 17

vomiting
hypovolemia
thiazide diuretics
increased renal production of HCO3

Question 18

respiratory acidosis mechanism

Answer 18

alveolar hypoventilation leads to CO2 retention

Question 19

in metabolic alkalosis, pH goes ____ and HCO3 goes ___

Answer 19

up

up

Question 20

in respiratory acidosis, pH goes ____ and PCO2 goes ___

Answer 20

down

up

Question 21

in respiratory alkalosis, pH goes ____ and PCO2 goes ___

Answer 21

up

down

Question 22

causes of respiratory acidosis

Answer 22

airway obstruction
respiratory muscle weakness
CNS depression
(anything that would lead you not to breath fast or deeply enough)

Question 23

respiratory alkalosis mechanism

Answer 23

hyperventilation leads to too much CO2 being lost

Question 24

causes of respiratory alkalosis

Answer 24

pain
panic attacks
pregnancy
pulmonary disease
pills (drugs)
problem with your brains

Question 25

7.32/10/98/8 | what is each number on the ABG?

Answer 25

pH/ CO2/ O2/ HCO3

Question 26

7.32/10/98/8 acidosis or alkalosis?

Answer 26

acidosis (7.32)

Question 27

7.32/10/98/8 | metabolic or respiratory

Answer 27

metabolic acidosis 7.32 is acidic CO2=10 is low, but low CO2 would cause alkalosis HCO3=8 is low which is driving the pH down

Question 28

7.32/10/98/8 | appropriate compensation or not?

Answer 28

look at CO2- metabolic acidosis (1.5 x 8) + 8 +/-2= 20 +/- 2 does not equal 10 so lungs are not compensating appropriately to try and increase pH second disorder is low PCO2= respiratory alkalosis

Question 29

what is winter's formula used for?

Answer 29

for metabolic acidosis ONLY: what CO2 should be if lungs are compensating appropriately

Question 30

winter's formula

Answer 30

(1.5 x HCO3) + 8 +/-2

Question 31

which has faster compensatory changes--metabolic or respiratory disorders? (think!)

Answer 31

in metabolic disorders, PCO2 compensates faster because ventilation can change quickly respiratory disorders take longer to change urinary pH in response

Question 32

compensation mechanism in metabolic acidosis

Answer 32

low HCO3 leads to low pH so respiratory rate increases to get rid of more CO2 and have an alkalotic effect and try to raise pH use winters formula to see if there is appropriate compensation

Question 33

compensation mechanism in metabolic alkalosis

Answer 33

high HCO3 leads to high pH, respiratory compensation by decreasing respiratory rate to increase PCO2 and increase pH

Question 34

compensation mechanism in acute respiratory alkalosis or acidosis

Answer 34

trick question, there's not really any compensation from the kidneys just that there may be some buffering of excess acid or base

Question 35

compensation mechanism of chronic respiratory acidosis

Answer 35

chronic high pCO2 and low pH leads to increased HCO3 by kidneys to try and raise pH final pH will not be as acidic

Question 36

compensation mechanism of chronic respiratory alkalosis

Answer 36

chronic low CO2 and high pH leads to lower HCO3 by kidneys to compensate and try to lower pH final pH will not be as alkalotic

Question 37

what is the anion-gap

Answer 37

represents the difference between the concentration of unmeasured anions (Cl-, HCO3-) and the the concentration of unmeasured cations (Na+, K+)

Question 38

what is a normal anion-gap

Answer 38

10-12

Question 39

high anion gap metabolic acidosis

Answer 39

anion gap > 12 due to increased concentration of acids like ketoacidosis or lactic acidosis

Question 40

formula to see if anion gap is high

Answer 40

2.5 x albumin (4)

Question 41

what is the delta delta ratio and when is it used

Answer 41

it is a ratio using the anion gap and serum bicarbonate to see if there is a second metabolic disorder occurring during high anion gap metabolic acidosis

Question 42

delta delta fomrula

Answer 42

measured- expected anion gap= number of bicarbs consumed to buffer anions serum bicarb-anion gap= shows what bicarb should be and confirms presence of a secondary disorder

Question 43

if delta delta predicted bicarbonate is lower than expected, the other disorder present is ...

Answer 43

non-gap metabolic acidosis

Question 44

if delta delta predicted bicarbonate is higher than expected, the other disorder present is ...

Answer 44

metabolic alkalosis (or chronic respiratory acidosis)

Question 45

7.22/34/98/17

Answer 45

non-gap metabolic acidosis with appropriate respiratory compensation

Question 46

causes of non-gap metabolic acidosis

Answer 46

diarrhea, drugs, renal tubular acidosis

Question 47

urine anion gap formula

Answer 47

[Na] + [K] - [Cl]

Question 48

positive urine anion gap is due to

Answer 48

kidney problems-renal acidification

Question 49

negative urine anion gap is due to

Answer 49

GI loss of bicarbonate (diarrhea)

Question 50

how much should HCO3 change in chronic respiratory acidosis?

Answer 50

3.5 for every change of 10 in CO2 from normal | if CO2 is 60, it should be 40 so 2 changes of 10, 3.5 x2=7

Question 51

how much should HCO3 change in chronic respiratory alkalosis?

Answer 51

5 for every change of 10 in CO2 from normal

Question 52

diabetic ketoacidosis labs would present as...

Answer 52

high anion gap metabolic acidosis | high gap because of ketones