48. Acid base

Question 1

Strong anions and cations

Answer 1

Anions. K Na Ca Mg
Cations Cl A-

Question 2

SID formula and normal values

Answer 2

Na + K + Mg + Ca - Cl - A-
+40 -44

Question 3

SID interpretation

Answer 3

Decrease Acidosis
Increase Alkalosis (contraction alkalosis if decrease volume)
Decrease 1 mEq decrease 1 mEq HCO3

Question 4

Hypoalbuminemia and acid base balance

Answer 4

Hipoalbuminemia produces metabolic alkalosis

Question 5

Lactate characteristics

Answer 5

L and D (both in Hartman’s)
L normal, D by bacteria
If > 2 clinically significant
If > 5 Met acidosis

Question 6

Types of met acidosis (high lactate)

Answer 6

Type 1. Decrease delivery / perfusion
Type 2. Despite normal perfusion. Cyanide, metformin, DKA, AIDS

Question 7

Where is lactate excreted

Answer 7

Liver

Question 8

Relation btw HCO3 and CO2 in alk/ac chronic/acute

Answer 8

Acute Resp Ac 1 : 10
Chronic Resp Ac 3 : 10
Chronic met alk 2 : 10
Acute Resp alk 1 : 0.2

Question 9

Acidosis effect in vascular resistance

Answer 9

Vasodilation

Question 10

Anion Gap
New
Corrected

Answer 10

NA+K - (Cl+HCO3)
NA+K - (Cl+HCO3+lactate)
AG + 0.25 (Alb norm - alb observed)

Question 11

Delta ratio (Increase anion gap) Formula and interpretation

Answer 11

AG - 12 / 24 - HCO3
< 0.4 Hyper Cl normal AG acid
< 1 normal AG acid
1 - 2 Pure anion gap acidosis
> 2 High AG acid

Question 12

In case of pH disbalance, when BE doesn’t change

Answer 12

BE doesn’t change in acute resp alk/ac

Question 13

What is the ketone dominant in urine

Answer 13

Acetoacetate

Question 14

Clearance of H+

Answer 14

65% Hb
27% CO2

Question 15

Expected HCO3

Answer 15