38: Acid Base Disorders

Question 1

arterial pH range

Answer 1

7.35-7.45

Question 2

intracellular pH range

Answer 2

7.0 - 7.3

Question 3

most important extracellular buffer system

Answer 3

bicarbonate

Question 4

two main organs that regulate the bicarb buffer system/ body acidity

Answer 4

lungs, kidneys

Question 5

how many acid-base disturbances can be present at once?

Answer 5

three (bc its not possible to breathe too fast and too slow)

Question 6

when do you need to calculate anion gap?

Answer 6

metabolic acidosis

Question 7

what do you need to calculate if pt has metabolic acidosis + hypoalbuminemia?

Answer 7

corrected anion gap

Question 8

two extra calculations to do if HAGMA is present

Answer 8

osmolar gap, delta-delta gap

Question 9

if compensation for an acidosis/alkalosis is inappropriate, what is present?

Answer 9

mixed acid-base disorder

Question 10

normal pCO2 range

Answer 10

35-45 mmHg

Question 11

normal HCO3 range

Answer 11

22-26 mEq/L

Question 12

normal anion gap and osmolality gap ranges

Answer 12

1. anion gap: 5-16

2. osmolality gap: 10-15

Question 13

normal serum N and K ranges

Answer 13

1. Na: 135 - 148

2. K: 3.5 - 4.5

Question 14

major reason to calculate anion gap

Answer 14

determine if metabolic acidosis is HAGMA or NAGMA

Question 15

three major reasons to calculate osmolar gap

Answer 15

1. screen for alcohol ingestions
2. screen for ketoacidosis
3. screen for lactic acidosis

Question 16

things that can cause increased osmolar gap

Answer 16

methanol, ethanol, diethylene glycol, isopropyl alcohol, ethylene glycol, propylene glycol

Question 17

Renal Tubular Acisosi

Answer 17

condition where net acid excretion by kidneys is impaired

Question 18

acidosis and alkalosis; associated with hyper and hypokalemia

Answer 18

acidosis hyperkalemia

alkalosis hypokalemia

Question 19

what causes the correlation between acidosis and hyperkalemia?

Answer 19

transcellular shift of cations H and K into and out of cells to maintain electroneutrality (more H into cells -> more K exits and vice versa)

Question 20

overarching cause of respiratory acidosis vs alkalosis

Answer 20

1. acidosis: anything that lowers RR or tidal volume, decreases dead space, or obstructs airway
2. alkalosis: anything that increases RR or tidal volume