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Clinical Entrance Exam > abg'S > Flashcards

abg'S Flashcards

1
Q

ROME

A

RESP opposite, Metabolic equal

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2
Q

Increased pH, decreased CO2 =

A

resp alkalosis

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3
Q

decreased pH, increased CO2=

A

resp acidosis

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4
Q

Increased pH, Increased HCO3 =

A

metabolic alkalosis

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5
Q

decreased pH, decreased HCO3=

A

metabolic acidosis

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6
Q

compensated:

A

pH is normal

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7
Q

Uncompensated:

A

ph is not normal

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8
Q

partially uncompensated:

A

nothing is normal

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9
Q

normal pH values:

A

7.35 -7.45

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10
Q

normal CO2 values:

A

35-45

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11
Q

normal HCO3 values:

A

22-26

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12
Q

Kussmals respirations

A

metabolic acidosis

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13
Q

HYPOVentilation

A

Resp acidosis

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14
Q

HYPERventilation

A

Resp alkalosis

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15
Q

increased K

A

Acidosis

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16
Q

decreased K

A

alkalosis

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17
Q

N/V/D typically associated with

A

Metabolic acidosis or alkalosis

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18
Q

Anion gap elevation found in

A

metabolic acidosis

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19
Q

Metabolic Acidosis Tx

A

sodium bicarb
decrease BG
Treat underlying Cause:
Lactic Acidosis, DKA, Uremia

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20
Q

Metabolic Alkalosis TX

A 
correct underlying cause
Replace K (and other electrolytes)
Acetazolamide 
Spironolactone 
Dialysis
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21
Q

Respiratory Acidosis TX

A 
Increase MV (RR)
Improve ventilation w/better tissue perfusion
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22
Q

Respiratory Alkalosis TX

A 
Decrease MV (RR)
"Breathing in paper bag" --> retain CO2
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23
Q

Causes of Resp. Alkalosis

A 
Hyperventilation
mechanical over-ventilation
High Altitudes
anxiety
ARDS
PE
hypoxia
fever
sepsis
pain
pregnancy
brain tumor
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24
Q

Causes for Resp Acidosis

A 
HYPOventilation /resp depression
Pulm edema
PNA
Asthma/ COPD/ Fibrosis
airway obstruction
Drug OD
Pneumothorax
MS or other NMD's
Stroke
Head injury/ CNS depression
Cardiac Arrest
Rebreathing - exhausted CO2 absorber; incompetent one=way valve
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25
Q

Causes for Metabolic Alkalosis

A 
Lost of Gastric Juices: vomiting or suctioning
Potassium wasting diuretics
MASSIVE TRANSFUSIONS
Hypokalemia
Hypercalcemia
Antacid overuse
use of steroids
Excessive NaHCO3
Increased mineralocorticoid - CUSHINGS SYNDROME, and HYPERALDOSTERONISM
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26
Q

Causes for Metabolic Acidosis

A 
Shock
Sepsis
DKA
starvation
Alcoholism
Salicylate toxicity
Diarrhea
RF
Hyperkalemia
Pancreatic / Lower GI Fistulas
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27
Q

Patient says “ I can’t catch my breath”… likely condition

A

Respiratory Acidosis = Increased CO2

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28
Q

Retention of CO2 by the lungs

A

Resp Acidosis

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29
Q

Muscle weakness typically associated with

A

Resp Acidosis

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30
Q

Muscle cramping and hyper reflexes are typically associated with

A

Resp Alkalosis

31
Q

Muscle twitching typically associated with

A

Met acidosis

32
Q

Lethargy, tremors, cramps, tingling, restless are likely associated with

A

met alkalosis

33
Q

anxiety, irritability, and seizures may be associated with

A

resp alkalosis

34
Q

Pale skin and mucosa, cyanosis can be found in

A

resp acidosis

35
Q

warm flushed skin likely associated with

A

metabolic acidosis

*vasodilation

36
Q

Elevated K associated with

37
Q

How is your K with alkalosis ?

38
Q

Compensatory Hypoventilation

A

Metabolic Alkalosis

39
Q

Compensatory Hyperventilation

A

Metabolic Acidosis

Kussmaul Respiration

40
Q

Large volume resuscitation with a NaCl solution associated with

A

Metabolic Acidosis

41
Q

Anion Gap formula=

A

Na+ - (Cl- + HCO3-) = 8-12 mEq/L

Major cations - major anions = anion gap

42
Q

Anion Gap Acidosis is

A

anion gap >14

accumulation of acid

43
Q

Non-gap acidosis is

A

anion gap < 14

loss of bicarbonate or ECF dilution

44
Q

mnemonic for gap acidosis:

A

“MUDPILES”

45
Q

mnemonic for non-gap acidosis:

A

“HARDUP”

46
Q

Normal anion gap =

A

8-12 mEq/L

47
Q

MUDPILES

A 
Gap Acidosis (>14):
M-methanol
U-uremia
D-DKA
P-paraldhyde
I-Isoniazid
L-Lactate (sepsis; cyanide poisoning)
E-Ethanol, Ethylene glycol
S-salicylates (inhibit krebs cycle)
48
Q

HARD UP

A 
Non-gap acidosis (<14):
H-HYPOaldosteronism
A-Acetazolamide
R-Renal tubular acidosis
D-Diarrhea or DROWNed in fluids
U-ureterosigmoid fistula
P-pancreatic fistula
49
Q

Decreased P50 or LEFT shift

A

resp alkalosis

50
Q

Would you correct PaCO2 in the pt with chronic respiratory acidosis (COPD)?

A

No. (in resp acidosis)

these pts normally retain bicarbonate and if you return their Co2 to normal then you’ve created metabolic alkalosis

51
Q

Metabolic compensation for resp alkalosis?

A

kidneys excrete HCO3- to return pH to normal

52
Q

Metabolic compensation for Resp acidosis?

A

kidneys excrete H

conserve HCO3

53
Q

Respiratory compensation for Metabolic acidosis?

A

PaCO2 decreases as a function of increased Mv (increased RR) ; hyperventilation ; kussmaul

54
Q

Respiratory compensation for metabolic alkalosis?

A

PaCO2 increases as a function of decreased Mv.

hypoventilation/decreased RR

55
Q

PaCO2 decreases 1-1.5mmHg for every

A

HCO3 decrease of 1 mEq/L

56
Q

PaCO2 increased 0.5-1 for every

A

HCO3 increase of 1 mEq/L

57
Q

Tx for Lactic acidosis

A

IVF
O2
cardiopulm support

58
Q

Tx for DKA

A

IVF and insulin

59
Q

Tx for uremia or drug induced (met acidosis)

60
Q

what is Acetazolamide?

A

carbonic anhydrase inhibitor

-increases renal excretion of HCO3-

61
Q

what is spironolactone?

A

a mineralocorticoid antagonist

62
Q

hypercarbia on brain

A

vasodilation

63
Q

hypercarbia on lungs

A

vasoconstriction

64
Q

Increased P50 shifts curve?

A

to the RIGHT –> releases more O2 to tissues

65
Q

CO2 stimulates the SNS to increase release of

A

catecholamines

  • increased HR, vasoconstriction, SVR
  • increased O2 consumption
  • increased demand on heart
  • increased risk for MI
66
Q

increased K activates

A

H+/K+ pump

-buffers CO2 acid in exchange for releasing K into the plasma

67
Q

increased Ca++ competes with

A

H+ for binding sites on plasma proteins
-acidosis: plasma pr buffer H+ and release Ca++ –> increasing inotropy

-alkalosis: plasma pr release H+ and bind Ca++ –> decreasing inotropy

68
Q

inotropy means

A

force of contraction

69
Q

CO2 freely diffuses across the

A

BBB

  • decreased CSF pH -> decreased Cerebrovascular resistance => increased CBF and ICP
  • increased CSF ph –>cerebral vasoconstriction ==> decreased CBF and ICP
70
Q

CO2 narcosis when PaCO2

71
Q

Henderson-Hasselbalch equation =

A

pH = pK + log [A-] / [HA]

or

pH = pK + log [HCO3-] / [CO2]

72
Q

Buffer Systems help to mitigate

A

pH changes

73
Q

Name the 3 buffer systems:

A
  1. Blood (HCO3 , Hgb)
  2. Respiratory compensation (PaCO2 alterations)
  3. Renal compensation:
    - reabsorption of HCO3
    - removal of titratable acids
    - formation of ammonia

Clinical Entrance Exam (21 decks)

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