20: Acid Base Disturbances

Question 1

Which is faster, respiratory compensation or renal acid excretion compensation?

Answer 1

Respiratory compensation

Question 2

Examples of neuromuscular disorders that can cause respiratory acidosis

Answer 2

ALS, MS, myasthenia gravis, polio, Guillain-Barre

Question 3

For every 10 mmHg increase in PaCO2, how much should HCO3 increase in acute and chronic respiratory acidosis?

Answer 3

Acute respiratory acidosis: increase of 1

Chronic respiratory acidosis: increase of 3.5

Question 4

For every 10 mmHg decrease in PaCO2, how much should HCO3 decrease in acute and chronic respiratory alkalosis?

Answer 4

Acute respiratory alkalosis: decrease by 2

Chronic respiratory alkalosis: decrease by 5

Question 5

What if the predicted change in HCO3 for compensation for respiratory acidosis or alkalosis isn’t as expected?

Answer 5

Mixed acid-base disorder

Question 6

Winter’s formula

Answer 6

PaCO2 = (1.5[HCO3]) + (8 +/- 2)

Question 7

Delta gap formula

Answer 7

Delta gap = calculated anion gap - normal anion gap (12)

Question 8

Acute respiratory acidosis symptoms

Answer 8

HA, confusion, anxiety, drowsiness, stupor, tremors, convulsions, possible coma

Question 9

Acute respiratory alkalosis symptoms

Answer 9

Light-headed, confusion, peripheral and circumoral parasthesias, cramps, syncope

Question 10

Metabolic acidosis symptoms

Answer 10

Mild is asymptomatic, but with a pH < 7.1 -> N/V, malaise

Question 11

Symptoms of mild metabolic alkalosis

Answer 11

S/S of underlying disorder

Question 12

Symptoms of severe metabolic alkalosis

Answer 12

Hypocalcemia -> HA, lethargy, tetany, delirium, seizures, possible weakness