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PHARM 557 > 04.04 Acid Base > Flashcards

04.04 Acid Base Flashcards

1
Q

T/F Acid-base disorders are disease states?

A

F

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2
Q

HCO3- Normal lab value

A

24-30 mEq/L

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3
Q

Normal Hydrogen ion concentration in the plasma is around?

A

40 nmol/L

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4
Q

There are several endogenous organic bases, what are two most common?

A
  1. HCO3-

2. LACTATE

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5
Q

Normal Arterial Blood pH

A

7.35-7.45

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6
Q

Arterial blood pH:

acidemia

A

<7.35

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7
Q

Arterial blood pH:

alkalemia

A

> 7.45

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8
Q

PaCO2 lungs normal value

A

35-45 mmHg

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9
Q

PaCO2 (mmHg):

Respiratory alkalosis value

A

<35 mmHg

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10
Q

PaCO2 (mmHg):

Respiratory acidosis value

A

> 45mmHg

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11
Q

TCO2(mEq/L):

Metabolic acidosis value

A

< or = 22 mEq/L

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12
Q

TCO2 (mEq/L):

Metabolic alkalosis value

A

> or = 26mEq/L

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13
Q

T/F-A patient can have concurrent respiratory acidosis and respiratory alkalosis

A

F

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14
Q

T/F- A patient cannot have concurrent metabolic acidosis and metabolic alkalosis

A

F

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15
Q

T/F- A patient may have concurrent metabolic and respiratory acid-base disorders

A

T

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16
Q

T/F-arterial pH value within the normal range (7.35-7.45) DOES NOT exclude the presence of acid-base disorders

A

T

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17
Q

PaO2 normal value

A

> 70

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18
Q

Anion Gap Value

A

??

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19
Q

Anion Gap Formula

A

Na-CL-HCO

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20
Q

An elevated PaCO2 is commonly seen with ____ ventilation, and _____ ventilation is associated with a LOW Pa CO2

A
  1. hypo

2. hyper

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21
Q

What is the normal range for the anion gap

A

3 - 11 mEq/L

22
Q

An elevated pH on ABGs and an elevated serum bicarbonate

concentration are hallmark signs of a _______

A

metabolic alkalosis

23
Q

___is an example of a medication that can induce a metabolic acidosis by inhibiting carbonic anhydrase

A

Acetazolamide

24
Q

Respiratory Acidosis, what is the compensation mechanism?

A

Kidneys reabsorb HCO3 - [↑pH, ↑HCO3]

25
Q

Metabolic Acidosis, what is the compensation mechanism?

A

Pulmonary Compensation:
Hyperventilation releases
CO2
[↑pH, ↓pCO2]

26
Q

Respiratory Alkalosis, what is the compensation mechanism?

A

Renal Compensation:
Kidneys excrete HCO3-
[↓pH, ↓ HCO3-]

27
Q

Metabolic Alkalosis, what is the compensation mechanism?

A

Pulmonary Compensation:
Hypoventilation retaining
CO2
[↓pH, ↑pCO2]

28
Q

Adverse clinical effects associated with a metabolic acidosis include a decrease in cardiac output,
____tension,[increase/decrease] in release of calcium from the
bone, and [increase/decrease] in protein catabolism

A
  1. hypo
  2. increase
  3. increase
29
Q

In the diagnosis

of metabolic acidosis, the calculation of an _________ is imperative to determine origin

A

anion gap

30
Q

anion gap lab is used in what condition?

A

metabolic acidosis

31
Q

Arteriolar constriction, reduction in coronary blood flow,
hypokalemia, tetany, seizures, and delirium are adverse
consequences seen with severe ______

A

alkalosis.

32
Q

Saline-responsive metabolic alkalosis is [more/less]

common than saline resistant

A

more

33
Q

Metabolic ALKALOSIS is divided into two categories based on what?

A

depending upon urine chloride levels

34
Q

Metabolic ACIDOSIS is divided into two categories based on what?

A

anion gap levels

35
Q

changes in potassium would be associated with what type of metabolic acidosis?

A

Non-Anion Gap

36
Q 
29 Year old woman in the ED for migraine
o pH of 7.52
o PaCO2 of 21 mmHg
o Chem Panel: 142, 112, 10, 4.8, 21, 101
o Respiratory rate is 30-35 bpm (due to pain)
A

she has alkalemia

She has respiratory alkalosis, and looking at the bicarbonate concentrations (21), she has mild metabolic acidosis

37
Q

Most common reason for increased respiratory rate, which leads to respiratory alkalosis:

A

Pain, nerves, white coat syndrome, drugs that stimulate respiration, intoxication

38
Q

Most patients who are hyperchloremic will most likely have some sort of ? (what condition)

A

metabolic acidosis

39
Q

metabolic alkalosis, secondary to dehydration

what would you expect in the following levels?
chloride

CO2

BUN

BUN to creatinine ratio

A

decreased

high

high

high

40
Q

Na value of 140, Cl of 110, and CO2 of 25

what is the anion gap?

A

140 - (110+25)= 5

41
Q

MUDPILES, is an acronym for what?

A

high conditions/drugs/etc cause increased ion gap metabolic acidosis

42
Q

increased ion gap metabolic acidosis

_ _ _ PILES

what high conditions/drugs/etc are the blanks?

A

-M stands for Methanol
-U stands for Uremia
o People who have uremia also have high BUN levels as well
-D stands for Diabetic Ketoacidosis

43
Q

increased ion gap metabolic acidosis

MUD _ _ _ ES

what high conditions/drugs/etc are the blanks?

A

-P stands for Paraldehyde (not used anymore)
-I stands for Ingestion of organic solutions
-L stands for Lactate
o For someone who has sepsis, lactate will increase

44
Q

increased ion gap metabolic acidosis

MUDPIL _ _

what high conditions/drugs/etc are the blanks?

A
  • E stands for Ethanol

- S stands for Salicylic Acid (aspirin)

45
Q

Normal anion gap metabolic acidosis is also called _________ because the kidneys reabsorb ___ instead of reabsorbing HCO3−.

A

hyperchloremic acidosis

Cl−

46
Q

Tx for metabolic alkalosis?

A

nclude volume replacement, correction of potassium and
magnesium deficits, and carbonic anhydrase inhibition
with acetazolamide.
Treatment of metabolic alkalosis
associated with a primary mineralocorticoid excess includes the use of spironolactone.

47
Q

A patient presenting with a respiratory acidosis will have a ___ pH and an ___ pCO2 on measurement of
ABGs

A

low

elevated

48
Q

[hypo/hyper]ventilation is closely linked with respiratory acidosis.

A

hypo

49
Q

The kidneys begin initiation
of compensation within 6-12 hours and may require
3-5 days for complete compensation

What condition?

A

respiratory acidosis

50
Q

Anxiety, confusion, personality changes, hallucinations,
motor disturbances, and dyspnea may be seen in
_______

A

respiratory acidosis

51
Q

Overdose of opioids or BZPs would most likely be seen in?

A

respiratory acidosis

52
Q

Tx for resp acidosis?

A

Treatment may include antidotes
such as flumazenil and naloxone if benzodiazepines or
opioids, respectively, are implicated in the development of hypoventilation.

Other treatments may include bronchodilators,
steroids, antibiotics, and ventilator support.
Alkali therapy should be avoided.

PHARM 557 (7 decks)

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