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Internal Med 2023 > acid base disorders > Flashcards

acid base disorders Flashcards

1
Q

acidaemia

A

low blood pH

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2
Q

alkalaemia

A

high blood pH

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3
Q

bicarbonate ions are mostly regulated by

A

the kidney and metabolism

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4
Q

CO2 is mostly regulated by

A

the lungs

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5
Q

how is pH of the blood detrrmined

A
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6
Q

why might acid build up in the blood

A

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

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7
Q

normal pH

A

7.35

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8
Q

compensatory response of metabolic acidosis

A

hyperventilation to eliminate CO2
so there are less hydrohen ions

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9
Q

anion gap

A

sodium - (chloride + bicarbonate)
normall 3-11

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10
Q

high anion gap metabolic acidosis

A

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)

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11
Q

substances that can lead to metabolic acidosis

A

propylene glycol
iron overdose
isoniazid overdose

promote lactic acid production

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12
Q

causes of metabolic acodisos

A

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

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13
Q

normal gap metabolic acidosiss

A

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

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14
Q

most common cause of normal anion gap metabolic acidosis

A

diarrhoea

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15
Q

type 2 renal tubular acidosis

A

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

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16
Q

addison disease

A

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

17
Q

spironolactone

A

can lead to metabolic acidosis by blocking aldosterone receptorss

18
Q

acetazolamide

A

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

19
Q

saline infusion

A

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

20
Q

total parenteral nutrition

A

causes accumulation of H ions

21
Q

causes of normal anion gap acidosis

A

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

22
Q

winters formula

A

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

23
Q

if the measured pCO2 is greater than winters formula calculation

A

metabolic acidosis and associated respiratory acidosis

24
Q

if the measured pCO2 is less than winters formular calculation

A

metabolic acidosis and respiratory alkalosis

25
Q

causes of respiratory acidosis

A

A airway obstruction
S sedative use

A acute lung disease

C chronic lung disease
O opiods
W weakeneing of respiratory muscles

26
Q

metabolic alkalosis

A

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

27
Q

loss of hydrogen ions happens by

A

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

28
Q

causes of metabolic akalosis

A

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

29
Q

respiratory alkalosis

A

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

30
Q

causes of respiratory alkalosis

A

P panic attacks
A anxiety attacks
S salicylates
T tumor

P pulomonary embolism
H hypoxaemia

31
Q

compensatory responses

A
32
Q

what is the compensation for respiratory acidosis

A

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

33
Q

what is the compensation for respiratory alkalosis

A

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

34
Q

what is the compensation of metabolic acidosis

A

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

35
Q

what is the compensation of metabolic alkalsosis

A

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

36
Q
A

Internal Med 2023 (51 decks)

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