acid base disorders

Question 1

acidaemia

Answer 1

low blood pH

Question 2

alkalaemia

Answer 2

high blood pH

Question 3

bicarbonate ions are mostly regulated by

Answer 3

the kidney and metabolism

Question 4

CO2 is mostly regulated by

Answer 4

the lungs

Question 5

how is pH of the blood detrrmined

Answer 5

Question 6

why might acid build up in the blood

Answer 6

increased production or ingestion
body cant get rid of it
excess HCO3 loss

Question 7

normal pH

Answer 7

7.35

Question 8

compensatory response of metabolic acidosis

Answer 8

hyperventilation to eliminate CO2
so there are less hydrohen ions

Question 9

anion gap

Answer 9

sodium - (chloride + bicarbonate)
normall 3-11

Question 10

high anion gap metabolic acidosis

Answer 10

anion gap > 12
bicarbonate ions decrease due to bonding with extra H ions
hydrogen ions may be from increased organism acid production eg. lactic acid or diabetic ketoacidosis in uncontrolled diabetes
or chronic renal faailure (inability to excrete hydrogen ions)
accidental. ingestions of ethylene glycol (antifreeze)

Question 11

substances that can lead to metabolic acidosis

Answer 11

propylene glycol
iron overdose
isoniazid overdose

promote lactic acid production

Question 12

causes of metabolic acodisos

Answer 12

M methanol
U Uraemia
D DKA
P Propylene gycol
I Iron tablets and isoniazid
L Lactic acidosis
E ethylene glycol
S salicylates

Question 13

normal gap metabolic acidosiss

Answer 13

decrease in bicarbonate is offset by build up of chloride so anion gap remains normal

Question 14

most common cause of normal anion gap metabolic acidosis

Answer 14

diarrhoea

Question 15

type 2 renal tubular acidosis

Answer 15

proximal convoluted tubule cant resorb bicarbonate
causes normal anion gap metabolic acidosis

Question 16

addison disease

Answer 16

adrenal glands dont produce enough aldosterone
normally aldosterone would instruct the kidneys to absorb more sodium in the distal tubule which is linked to hydrogen ion secretion
more hydrogen remains in the blood in addisons disease

Question 17

spironolactone

Answer 17

can lead to metabolic acidosis by blocking aldosterone receptorss

Question 18

acetazolamide

Answer 18

lowers bicarbote resorbtion in the proximal tubule
leads to bicarbonate wasting
normal anion gap metabolic acidosis

Question 19

saline infusion

Answer 19

standard 0.9 saline soltuion pH of 5.5
can cause normal anion gap metabolic acidosis

Question 20

total parenteral nutrition

Answer 20

causes accumulation of H ions

Question 21

causes of normal anion gap acidosis

Answer 21

H hyperalimentation
A addison disease
R renal tubular acidosis
D diarhhoea
A acetazolamide
S spironolactone
S saline infusion

Question 22

winters formula

Answer 22

calculates the appropriate respiratory compensation for respiratory acidosis
(1.5 x HCO3 +8) +/-2

Question 23

if the measured pCO2 is greater than winters formula calculation

Answer 23

metabolic acidosis and associated respiratory acidosis

Question 24

if the measured pCO2 is less than winters formular calculation

Answer 24

metabolic acidosis and respiratory alkalosis

Question 25

causes of respiratory acidosis

Answer 25

A airway obstruction S sedative use A acute lung disease C chronic lung disease O opiods W weakeneing of respiratory muscles

Question 26

metabolic alkalosis

Answer 26

loss of H ions or gain of HCO3 ions compensatory response is immidiate hypoventilation which will retain CO2

Question 27

loss of hydrogen ions happens by

Answer 27

GI tract - vomiting kidneys - too much aldosterone (hyperaldosteronism)

Question 28

causes of metabolic akalosis

Answer 28

L loop diuretics A antacid use V vomiting A alosterone increase UP

Question 29

respiratory alkalosis

Answer 29

hyperventilation causes too much CO2 to be lost from the lungs pH levels increase kindeys decrease bicarbonate ion resorbtion to compensate

Question 30

causes of respiratory alkalosis

Answer 30

P panic attacks A anxiety attacks S salicylates T tumor P pulomonary embolism H hypoxaemia

Question 31

compensatory responses

Answer 31

Question 32

what is the compensation for respiratory acidosis

Answer 32

acute compensation: buffers in blood chronic compensation: incrrease of resorbtion of HCO3 by proximal convoluted tubules increase in excretion of H as H2PO4 and NH4 from the distal convoluted tubule and collecting duct

Question 33

what is the compensation for respiratory alkalosis

Answer 33

acute compensation: buffers in blood chronic compensation: decreased resorption of HCO3 by proximal convoluted tubule and decrease in renal extretion of H

Question 34

what is the compensation of metabolic acidosis

Answer 34

stimulation of medullary chemoreceptors causes increase in respiraatory rate and todal volume

Question 35

what is the compensation of metabolic alkalsosis

Answer 35

decreased stimulation of medullary chemoreceptors decrease in respiratory rate and tidal volume