Flashcards in pH Disorders Deck (19)

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1

## What is the difference between Acidemia vs. Acidosis?

###
acidemia is the pH's change away from the reference range (so just a description of the lab)

acidosis refers to the abnormal condition or process that contributes to the pH's change

(same difference for alkalemia and alkalois)

2

## What is the normal pH range?

### 7.36-7.44

3

## What is the normal pCO2 range?

### 38-42 mm hg

4

## What is the normal HCO3 range?

### 22-28 mEq/L

5

## What are the implications of the henderson-Hasselbach equation?

###
it's the HCO3/H2CO3 buffer system

Basically, if pCO2 goes up, then pH goes down

If HCO3 goes up, then pH goes up

CO2 is the acid and HCO3 is the base

6

## What are Dr. Li's steps for working through acid base problems?

###
identify all the abnormalities (pH/CO2/bicarb)

acidosis vs alkalosis

metabolic or respiratory

acute or chronic

calculate anion gap

calculate the expected pCO2 range

7

## How do you calculate the anion gap?

### Na - (Cl + HCO3)

8

## What's the normal range for anion gap?

### 7-16 (12 typically used)

9

## WHat are the normal "unmeasured" anions in the gap?

###
phosphates

sulfates

albumin

10

## If the anion gap is over 20, but the pH and bicarb is normal, does the patient have an acidosis?

###
YES - anion gap over 20 defines metabolic acidosis regardless of what the pH or bicarb are doing, which is why you always need to calculate it

just means there is a mixed process going on

11

## Why do you need to calculate the expected pCO2 range?

### it determines whether respiratory compensation is adequate or under or over-compensated

12

## How do you calculate the expected pCO2 range?

### 1.5 x (measured HCO3) + 8 +/- 3

13

## If the pCO2 is above the expected range, what is the secondary process?

### respiratory acidosis even if the pCO2 is below 40

14

## If the pCO2 is less than the expected range, what's oging on?

### they're not compensating appropriately, so there is a concomitant respiratory alkalosis

15

## If there is an anion gap, what do you need to calcualate next? Why?

###
the excess anion gap (or delta gap)

It allows you to determine the "corrected" bicarbonate to see whether there are any other metabolic disturbances

16

## How do you calculate the excess anion gap?

### Calculated AG - 12

17

## How do you calculate the corrected bicarbonate?

### Corrected bicarb = measured bicarb + excess anion gap

18

## A corrected bicarb over what will reveal an underlying primary metabolic alkalosis?

### over 30

19