Acid Base Disorders

Question 1

With increase H+ what is the condition?

Answer 1

Acidosis

Question 2

With decreased H+ what is the condition?

Answer 2

Alkalosis

Question 3

What is the normal CO2 value?

Answer 3

35-45 mmHg

Question 4

What is the normal Bicarb value?

Answer 4

22-26 mEq/L

Question 5

What abnormalities exist in metabolism when a patient is acidotic?

Answer 5

Hyperkalemia

Question 6

What abnormalities exist in metabolism when a patient is alkalotic?

Answer 6

• Decreased push of protons into the cell
• This means that the calcium, mag, K, are not getting pushed out of the cells so they can drop ECF

Question 7

What abnormalities exist in the cardiovascular system when a patient is acidotic?

Answer 7

• Decreased cardiac output
• Vasodilation
• Increased ectopic rhythms from unstable cellular function
• Hyperkalemia

Question 8

What abnormalities exist in the cardiovascular system when a patient is alkalotic?

Answer 8

• Leads to excitability
• Ventricular tachyarrhythmias
• SVT
• Hypokalemia

Question 9

What abnormalities exist in the respiratory system when a patient is acidotic?

Answer 9

• Tachypnea
• Can drop CO2 to about 10 at lowest point
• Right shift

Question 10

What abnormalities exist in the respiratory system when a patient is alkalotic?

Answer 10

• Low respiratory rate
• Left shift

Question 11

What abnormalities exist in the CNS when a patient is acidotic?

Answer 11

• Decreases neurotransmitter release
• Decreased mental status
• Lethargic

Question 12

What abnormalities exist in the CNS when a patient is alkalotic?

Answer 12

• Increase action potentials
• Seizures
• Tetany

Question 13

What is the only intracellular buffer?

Answer 13

Hemoglobin

Question 14

What does MUDPILES stand for?

Answer 14

Metabolic acidosis

M - Methanlol
U - Uremia
D - DKA
P - Paraldaehyde
I - INH/Iron
L - Lactic Acid
E - Ethylee glycol
S - Salicylates

Question 15

What is a normal anion gap?

Answer 15

8-15

Question 16

What is a wide anion gap?

Answer 16

> 15

Question 17

Metabolic/Respiratory Acidosis/Alkalosis?

Patient is/has been vomiting?

Answer 17

Metabolic alkalosis

Question 18

Metabolic/Respiratory Acidosis/Alkalosis?

Patient is a diabetic?

Answer 18

Metabolic acidosis

Question 19

Metabolic/Respiratory Acidosis/Alkalosis?

Patient is a smoker/has COPD?

Answer 19

Respiratory acidosis

Question 20

Metabolic/Respiratory Acidosis/Alkalosis?

Patient has a history of liver disease?

Answer 20

Respiratory alkalosis

Question 21

Metabolic/Respiratory Acidosis/Alkalosis?

Patient with recent heavy ETOH use?

Answer 21

Metabolic acidosis

Question 22

Metabolic/Respiratory Acidosis/Alkalosis?

Patient has/had diarrhea?

Answer 22

Metabolic acidosis

Question 23

Metabolic/Respiratory Acidosis/Alkalosis?

Patient is tachypneic?

Answer 23

Respiratory alkolosis

Question 24

Metabolic/Respiratory Acidosis/Alkalosis?

Patient is hypotensive?

Answer 24

Metabolic acidosis

Question 25

Metabolic/Respiratory Acidosis/Alkalosis? Patient is a post-respiratory/cardiac arrest?

Answer 25

Respiratory acidosis

Question 26

What is the gold standard for evaluating acid-balance?

Answer 26

ABG

Question 27

CO2 is the breakdown of what acid

Answer 27

Carbonic acid

Question 28

CO2 is the result of what metabolite metabolism

Answer 28

carbs and fat

Question 29

What is the treatment for respiratory acidosis?

Answer 29

Assist with ventilation - Bronchodilators - O2, Intubation

Question 30

What is the treatment for respiratory alkolosis?

Answer 30

Typically no additional treatment beyond treatment of underlying problem - need to slow breathing (slow minute ventilation if ventilated)

Question 31

What is the treatment for metabolic acidosis?

Answer 31

Insulin and volume resuscitation for DKA​ +/- Sodium bicarb if severe (pH<7.1, HCO3<6)