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Flashcards in AcidBase Pathologies Deck (14)
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1

Normal pH range

7.35-7.45

Most common normal = 7.40

2

Normal PCO2 range

35-45 mmHg

Most common normal = 40 mmHg

3

Normal HCO3- range

22-28 mEq/L

Most common normal = 24

4

Basic metabolic panel includes what?

Na+/K+/Cl-/HCO3-/BUN/Creatinine/Glucose

CO2 = HCO3-

5

Arterial blood gas includes what?

pH

PaO2

PaCO2

HCO3-

SaO2

**PCO2 = H+/acid

6

What are causes of respiratory acidosis?

Decreased central respiratory drive
- opiods
- sedative
- encephalopathy

Decreases neuromuscular/thoracic cage function
- polio
- Guillain-Barre
- myasthenia gravis
- obesity

Increased dead space
- COPD
- ARDS

7

What are causes of respiratory alkalosis?

Anything that leads to hyperventilation
- anxiety
- panic disorders
- pain
- high altitudes
- pulmonary embolisms

8

What are causes of metabolic alkalosis

Any loss of H+
- vomiting
- hyperaldosteronism
- overuse of loop diuretics w/ secondary hyperaldosteronism
- severe hypokalemia (causes increased intracellular H+ shift and increased renal H+ excretion)
- contraction alkalosis (loss of significant amounts of fluid high in Na+/Cl-, but low in HCO3-) (includes loop diuretics and CHF)

9

Causes of metabolic acidosis

There are a lot and have to calculate the anion gap.

Causes are divided into 2 subcategories
1) involving an additional acidic substance in the blood
- if anion gap > 12

2) those not involving an additional substance in the blood
- if anion gap <12 or normal

10

Anion gap

Determines the levels of non Na+/Cl-/HCO3- in the blood

Equation
Na+ - ([HCO3-] + [Cl-]) = anion gap

**Normal = 12 (8-16)**

***on a BMP, CO2=HCO3-***

11

What are the 4 general types of anion gap metabolic acidosis?

1) lactic acidosis

2) ketoacidosis

3) toxins/drugs

4) severe kidney failure

subtypes of these 4 are “MUDPILES”
Methanol
Uremia
Diabetic Ketoacidosis
Propylene glycol
Lactic Acidosis
Ethylene glycol
Salicylate

12

Osmolality gap

Used to further differentiate anion gap metabolic acidosis causes

13

Hyperchloremic metabolic acidosis

A non-anion gap metabolic acidosis where Cl- elevates to overtake normal HCO3- levels

Anion gap will show normal, but bicarbonate will be low and Cl- will be elevated

14

Causes of non-anion cap metabolic acidosis

Loss of bicarbonate
- diarrhea
- proximal (type 2) renal tubular acidosis (causes decreases reabsorption of bicarbonate)
- chronic acetazolamide use

Reduced acid excretion
- Distal (type 1) renal tubular acidosis
- hypoaldosteronism
- overuse of spironolactone

Relative hypercholremia (drive HCO3 into cells which leads to acidosis in blood)