Acid/Base Disorders Flashcards Preview

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Flashcards in Acid/Base Disorders Deck (17):
1

Rule #1:

Look at pH from ABG:

if > 7.40 = primary alkalosis

2

Rule #2:

Calculate anion gap

elevated = primary metabolic acidosis OR mixed acid base problem

3

Rule #3:

If elevated anion gap, calculate osmol gap

(2 x Na) + (Gluc/18) + (BUN/2.8) = 285ish if normal

subtract that value from measured osmolarity

= 10 is normal

abnormal indicates toxin ingestion

4

Rule #4:

Calculate excess anion gap:

calculated AG - 12... add answer to measured bicarb

should = 24-26

low = non-anion gap acidosis

high = underlying metabolic alkalosis

5

Rule #5:

Clinical picture!!

6

Normal ABG with elevated anion gap= ?

metabolic alkalosis AND metabolic anion gap acidosis

7

Findings of mixed metabolic acidosis and respiratory alkalosis:

lower PCO2 than expected for acidosis

8

Findings of mixed metabolic alkalosis and respiratory acidosis:

higher than expected HCO3- for acidosis

9

Mixed resp and metabolic alkalosis?

high bicarb

low PCO2

10

MUDPILES???

DDx for metabolic acidosis

Methanol

Uremia--Cr over 5, BUN over 60

Dka and Aka (EtOH increases osm gap)

Paraldahyde

Iron

Lactic acid

Ethylene glycol

Salicylates

11

Primary disturbance in metabolic alkalosis:

increased plasma HCO3-

12

Primary disturbance in respiratory acidosis:

increased arterial PCO2

13

Acute compensation for resp acidosis:

HCO3- rises 1 mEq for each rise of 10 pCO2

14

Chronic compensation for resp acidosis:

HCO3- rises 3 mEq for each rise of 10 pCO2

15

Primary disturbance in respiratory alkalosis:

decreased arterial CO2

16

Acute compensation for respiratory alkalosis:

HCO3 falls by 2 mEq for each drop of 10 pCO2

17

Chronic compensation for respiratory alkalosis:

HCO3 falls by 4 mEq for each drop of 10 pCO2