ABGs Flashcards

Question

How does the body's produce acid in excess leading to metabolic acidosis

Answer 1

LACTIC ACIDOSIS Hypoperfusion (of whole body in shock and part of body in embolus) Leading to anaerobic metabolism --> Lactic acidosis KETOACIDOSIS Imbalance of insulin and glucagon --> High glucose E.g. Uncontrolled DM, alcoholic ketoacidosis and starvation ketoacidosis

Answer 2

Hypopersion (shock or embolus) Severe hypoxia Severe convulsions (resp arrest) Strenuous exercise (dehydration)

Answer 3

Kidney function: Resorbs filtered bicarbonate + regenerates bicarbonate consumed by buffering Acute and chronic renal failure (increases anion gap) Renal tubular acidosis (normal gap)

Answer 4

Diarrhoea | Renal tubular acidosis

Answer 5

Below the pylorus In stomach HCl is excreted

Answer 6

Increase in: HCO3- loss and H+ gain + Volume depletion Volume depletion = RAAS activation = Cl retained So lo HCO3 is replaced by Cl

Answer 7

Must lower pCO2, therefore RR much increase to blow of excess CO2 e.g. Kussmaul respiration

Answer 8

A laboured deep, rapid pattern of breathing

Answer 9

``` Initiating process (commonly Loss of H+ ions) Maintaining process ```

Answer 10

From the gut (above the pylorus) | From the kidney (furosemide and thiazide)

Answer 11

A process which impairs the kidneys to excrete bicarbonate e.g. Cl depletion group. When Cl- in the renal tubular fluid is LOW, bicarb is resorb to maintain electrical neutrality

Answer 12

Type 1 (Hypoxaemic) - Oxygenation failure (PaO2 decrease) - PaO2 <8kPa ``` Type II (Hypercapnic) -Ventilatory failure (PaO2 decrease, PaCO2 increase, pH decrease) ```

Answer 13

Metabolic alkalaemia Initiating process: Loss of HCl from stomach Maintaining process: When kidneys resorb Na+ in tubule, HCO3- moves with it. Normally would be Cl- BUT in vomit this is depleted

Answer 14

2K+ + 2Na+ + Glucose + Urea

Answer 15

Myasthenia gravis is a chronic autoimmune neuromuscular disease that causes weakness in the skeletal muscles, which are responsible for breathing and moving parts of the body, including the arms and legs. The name myasthenia gravis, which is Latin and Greek in origin, means "grave, or serious, muscle weakness. --> Respiratory acidosis

Answer 16

Indications: Hypoxaemia (PaO2 <8kPa) with normocapnia (PaCO2 < 6kPa) Due to V/Q mismatch E.g. - Reduced ventilation and normal perfusion e.g. pulmonary oedema and bronchoconstriction - Reduced perfusion with normal ventilation e.g. PE

Answer 17

Indications: Hypoxaemia (PaO2 <8kPa) with hypercapnia (PaCO2 > 6kPa) Due to alveolar hypoventilation E.g. - Increase resistance due to airway obstruction e.g. COPD - Reduced compliance of the lung tissue/chest wall (e.g. pneumonia/rib fractures/obesity) - Reduced strength of the respiratory muscles (e.g. Guillain–Barré / motor neurone disease) - Drugs acting on the respiratory centre reducing overall ventilation (e.g. opiates)

Answer 18

In these circumstances, the CO2 and HCO3– will be moving in opposite directions (e.g. ↑ CO2 ↓ HCO3– in mixed respiratory and metabolic acidosis).

Answer 19

Respiratory depression (e.g. opiates) Guillain-Barre – paralysis leads to an inability to adequately ventilate Asthma Chronic obstructive pulmonary disease (COPD) Iatrogenic (incorrect mechanical ventilation settings)

Answer 20

Anxiety – often referred to as a panic attack Pain – causing an increased respiratory rate Hypoxia – resulting in increased alveolar ventilation in an attempt to compensate Pulmonary embolism Pneumothorax Iatrogenic (excessive mechanical ventilation)

Answer 21

GI loss of HCO3— diarrhoea, ileostomy, proximal colostomy Renal tubular acidosis (retaining H+) Addison’s disease (retaining H+)

Answer 22

Gastrointestinal loss of H+ ions – vomiting/diarrhoea Renal loss of H+ ions – loop and thiazide diuretics / heart failure / nephrotic syndrome / cirrhosis / Conn’s syndrome Iatrogenic – addition of alkali (e.g. milk-alkali syndrome)