CR III - Metabolic Acidosis and Alkalosis Flashcards Preview

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Flashcards in CR III - Metabolic Acidosis and Alkalosis Deck (16):
1

What is the most common acid-base disturbance?

Metabolic acidosis

2

What disturbance is it if your anion gap is >30? <24?

>30 = lactic acidosis or ketoacidosis
<24 - other

3

What 6 things can cause high anion gap?

Metabolic acidosis
Lab error
Severe volume depletion (hyperalbumin)
Respirtory alkalosis
Severe hyperphosphatemia
Increased anionic paraproteins - IgA

4

What is the most common cause of a negative anion gap?

Lab error

5

What metabolic acidosis has a normal ion gap?

If acid accumulating in HCl

6

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

7

Compensation for metabolic acidosis causes what shift to the oxyhemaglobin curve? What does it facilitate?

Shift to right
Favors oxygen delivery to tissues

8

What three cardiac responses are seen in metabolic acidosis?

Decreased contractility
Arterial vasodilation
Decreased vascular resistance

9

What is used to treat metabolic acidosis?

Lactate ringer

10

Should you extubate patients with metabolic alkalosis?

No

11

What should be removed if possible in someone with metabolic alkalosis?

NG tube

12

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

13

What is seen in Bartters syndrome? How do pts present?

Defect in Na-K-Cl
Present - hypokalemic, hypochloremic metabolic alkalosis

14

What is seen in Gitelmans?

Present Hypomag and hypocalecemia (due to Na-K-Cl defect)

15

What is seen in Liddles?

Increased Na channel activity in collecting duct
Rpesent: volume expansion, hypokalemic alkalosis, normal aldosterone

16

What can cause Type B lactic acidosis?

Metformin