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RUSVM Clin Path > Acid-Base Disorders > Flashcards

Acid-Base Disorders Flashcards

1
Q

maintenance of pH is important for

A

protein structure

metabolism and enzymes

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2
Q

T/F small changes in pH=large changes in [H+]

A

true

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3
Q

pH is determined by

A
  1. pCO2
  2. Addition or removal of acids (H+)
  3. Strong ion movements
  4. Serum proteins, phosphates, and other weak acids
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4
Q

regulatory systems

A

Extracellular and intracellular buffers

Rate of alveolar ventilation (pCO2)

Renal excretion of H+

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5
Q

buffer systems

A

minimize the changes in [H+]

prevent sudden changes in pH

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6
Q

components of the buffer system

A

Bicarbonate/carbonic acid

Non-bicarbonate components

  • Hemoglobin
  • Plasma proteins
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7
Q

what happens when you add H+ to the system

A

H+ combines with HCO3- to form H2O + CO2 –> CO2 is exhaled (CO2 thought of as an acid, increases with increase in H+)

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8
Q

venous blood samples

A

‒ Good for evaluating acid base status

‒ Useful in most clinical situations

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9
Q

arterial blood samples

A

‒ Evaluates pO2

‒ Useful for evaluating cardiopulmonary function

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10
Q

blood collection

A

Anaerobic: avoid exposure to air

Whole blood from a free flowing vessel –> heparin tube

Analyze ASAP (>15 min put on ice-ice-baby)

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11
Q

what is TCO2

A

BICARB!!!!

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12
Q

pCO2 represents

A

respiratory system

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13
Q

TCO2 represents

A

metabolic system (BICARB!!)

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14
Q

metabolic acidosis

A

↑ acid in the absence of ↑ pCO2

↓ base, ↓ HCO3-

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15
Q

metabolic alkalosis

A

↓ acid in the absence of ↓ pCO2

↑ base, ↑ HCO3-

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16
Q

T/F measurement of TCO2 is an estimate of bicarb

A

true

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17
Q

T/F TCO2 is NOT a measurement of pCO2

A

TRUE!!!

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18
Q

base excess: metabolic alkalosis

A

(+) BE

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19
Q

base excess: metabolic acidosis

A

(-) BE

20
Q

what is base excess used to calculate

A

bicarb dosage in IVF

21
Q

What are the 4 Primary Acid Base Abnormalities

A
  1. Respiratory acidosis
  2. Metabolic acidosis
  3. Respiratory alkalosis
  4. Metabolic alkalosis
22
Q

compensation=

A

opposite system, opposite type

23
Q

TCO2 is ________; pCO2 is ________.

A

Bicarb; an acid

24
Q

respiratory acidosis

A 
hypoventilation 
­- Anesthesia
­- Diffuse pulmonary disease
- Intrathoracic lesions
- CNS disease
25
Q

respiratory acidosis: compensation

A

Secondary metabolic alkalosis = retention of HCO3-

26
Q

2 ways metabolic acidosis can happen

A

↑ in acid or ↓ in base (diarrhea cha cha cha)

27
Q

High Anion Gap Acidosis (Metabolic acidosis)

A

Increase in nonvolatile acids (KLUE)
Ketones

­Lactate

Uremic acids (phosphates, sulfates)

Ethylene glycol metabolites (toxins)

28
Q

at what value is anion gap considered a problem

A

> 25

29
Q

what is anion gap based on

A

the principle of electroneutrality

Used to detect unmeasured anions (KLUE)

30
Q

anion gap equation

A

AG = (Na+ + K+) − (Cl− + HCO3−)

31
Q

loss of HCO3-

A

‒ GI loss from diarrhea

‒ Intestinal ileus

‒ Salivation (ruminants) – choke

‒ Urinary loss

‒ Titration

32
Q

short term metabolic acidosis compensation

A

secondary respiratory alkalosis –> ↑ ventilation with ↓ pCO2

33
Q

long term metabolic acidosis compensation

A

Increased renal excretion of H+ with retention of HCO3

34
Q

respiratory alkalosis

A 
hyperventilation 
­- Hypoxemia
- Pain, anxiety, etc.
- Hyperthermia
- Drugs that stimulate the medullary respiratory center
35
Q

respiratory alkalosis compensation

A

Secondary metabolic acidosis = renal retention of H+

36
Q

2 ways metabolic alkalosis can happen

A

↓ in acid (vomitting) or ↑ in base

37
Q

hypochloremic metabolic alkalosis

A

Monogastrics: severe vomiting, pyloric outflow obstruction (GDV)

­Ruminants: sequestration of fluid in abomasum and forestomachs (LDA and RDA)

38
Q

hypochloremic metabolic alkalosis can result in

A

paradoxical aciduria

39
Q

what two things are required for paradoxical aciduria

A

hypochloremia

volume depletion

40
Q

causes of excessive renal loss of H+

A

diuretics

increased mineralocorticoid activity

41
Q

short term compensation for metabolic alkalosis

A

decreased ventilation=↑ PCO2

42
Q

long term compensation for metabolic alkalosis

A

Increased renal retention of H+ with decreased generation of HCO3-

43
Q

what are mixed disturbances

A

2 primary disturbances occurring simultaneously

44
Q

when do we suspect a mixed disturbance

A

Animal with electrolyte disturbances

or

­Animal with a disease associated with AB disturbance and normal blood gas values

45
Q

example of mixed disturbance

A

cow with abomasal volvuus (hypochloremic metabolic alkalosis) and shock (metabolic acidosis- ↑ lactate)

46
Q

T/F mixed disturbances can occur when the compensatory response in moving in the wrong direction

A

true

Horse with low intestinal obstruction (colic) that is hypoventilated when anesthetized for surgery

RUSVM Clin Path (11 decks)

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