Acid Base Disturbances (Tutorial Session 16/8/2023) Flashcards
What is the only organ in the body which can excrete acid?
The kidneys
What is the usual pathophysiology of respiratory acidosis?
The patient is unable to clear carbon dioxide, generally due to an airways disease
What classifies Type 1 Respiratory Failure?
Low oxygen in the absence of carbon dioxide retention
What classifies Type 2 Respiratory Failure?
Carbon dioxide retention
What should you always remember if the pH appears relatively normal when assessing an acid-base disorder?
This is likely because the compensatory mechanisms have taken effect – check to see if this is reflected by the bicarbonate or carbon dioxide.
What is a normal anion gap acidosis also called?
Hyperchloraemic acidosis
What is a high anion gap acidosis also called?
Normochloraemic acidosis
What is the likely timeline with a high anion gap (normochloraemic) acidosis and a normal anion gap (hyperchloraemic) acidosis?
Chloride tends to increase as a compensatory mechanism, so if chloride is normal (and anion gap is thus high), it is generally because it hasn’t had time to adjust yet (i.e. an acute acidosis), whereas if chloride is high (and anion gap is normal), this is more indicative of a subacute or chronic cause of acidosis.
What is the most common cause of normal anion gap (hyperchloraemic) metabolic acidosis?
Renal failure
How does insulin affect potassium?
Insulin increases the uptake of potassium into cells, dropping the serum concentration
How does bicarbonate affect potassium?
Bicarbonate increases the uptake of potassium into cells, dropping the serum concentration
What are 3 commons causes of high anion gap metabolic acidosis?
- Ketoacidosis
- Poisoning
- Renal failure
What is a common way subarachnoid haemorrhages are managed in ICU?
Patients are made to hyperventilate through their ventilator to decrease pCO2 and thus intracranial pressure and cerebral blood flow
