Flashcards in CR III - Metabolic Acidosis and Alkalosis Deck (16):
What is the most common acid-base disturbance?
What disturbance is it if your anion gap is >30? <24?
>30 = lactic acidosis or ketoacidosis
<24 - other
What 6 things can cause high anion gap?
Severe volume depletion (hyperalbumin)
Increased anionic paraproteins - IgA
What is the most common cause of a negative anion gap?
What metabolic acidosis has a normal ion gap?
If acid accumulating in HCl
If normal plasma anion gap, what should be checked? What does a positive or negative value here mean?
Urine anion gap
Positive - renal tubular acidosis (diminished H+ secretion)
Negative - diarrhea or external loss of pancreatic/biliary secretions
Compensation for metabolic acidosis causes what shift to the oxyhemaglobin curve? What does it facilitate?
Shift to right
Favors oxygen delivery to tissues
What three cardiac responses are seen in metabolic acidosis?
Decreased vascular resistance
What is used to treat metabolic acidosis?
Should you extubate patients with metabolic alkalosis?
What should be removed if possible in someone with metabolic alkalosis?
What 4 are saline responsive metabolic alkalosis causes? Non-responsive?
Responsive - vomiting, diuretics, posthypercapnia, Low Cl intake
Non-responsive - edema, mineralcorticoid excess, severe hypokalemia, renal failure
What is seen in Bartters syndrome? How do pts present?
Defect in Na-K-Cl
Present - hypokalemic, hypochloremic metabolic alkalosis
What is seen in Gitelmans?
Present Hypomag and hypocalecemia (due to Na-K-Cl defect)
What is seen in Liddles?
Increased Na channel activity in collecting duct
Rpesent: volume expansion, hypokalemic alkalosis, normal aldosterone