Acid Basae

Question 1

What accounts for pH

Answer 1

H+

Question 2

Kidney compensates acid by producing…

Answer 2

ammonia

Question 3

7.36 =

Answer 3

neutral (7.35-7.45)

Question 4

pH = 7.25 and shows improvement ..

Answer 4

acidemic

Question 5

order of ABG

Answer 5

pH/PCO2/O2/Bicarb

Question 6

Indications for ordering ABG

Answer 6

resp failure 
severe dz which may lead to met acid 
vented pts 
sleep studies 
severely unwell pts

Question 7

where are chemoreceptors located

Answer 7

internal carotids, aotic arch. detect change in pH

Question 8

normal range and math value 
pH
CO2
Bicarb
AG 
Albumin

Answer 8

pH = 7.35-7.45   - 7.4
pCO2 = 35-45, 40 
Bicarb = 22-26, 24 
Anion Gap = 10-14, 12 
Albumin = 4,4

Question 9

renal compensation

Answer 9

1. reabsorption of HCO3
2. Formation of titratable acid (acid that can lose +)
3. excretion of NH4+

Question 10

Resp Acid

Answer 10

High CO2.

increase 10 CO2 = increase 1 HCO3= pH down 0.08
Chronic increase 4 HCO3 = pH down 0.03

Question 11

Resp Alk

Answer 11

Low CO2.

Decrease 10 CO2 = decrease 2 HCO3= pH down 0.08
Chronic decrease 5 HCO3 = pH down 0.03

Question 12

Met Alk

Answer 12

High HCO3

increase 10 HCO3 = increase 6 PCO2

Question 13

Met Acid

Answer 13

Low HCO3

acute: PCO2=1.5*(HCO3) + 8
chronic: PCO2 = HCO3 + 15
These are the expected PCO2 change. if actual is > expected, then Resp Acid also

Question 14

Henderson-Hasselbach equation

Answer 14

[H+] = 24 * PCO2/HCO3

45 H+ = 7.35 pH
35 H+ = 7.45 pH

Question 15

Anion Gap

Answer 15

only for Met Acidosis
Na+ - (Cl + HCO3)
Normal = 0.2albumin + 1.5phos

Question 16

___ contribuites almost the whole value of the AG

Association between __ and AG?

Answer 16

albumin

1 decrease of Albumin = 2.3 decrease AG

Question 17

lactic acidosis

Answer 17

most common form of increased anion gap.

>4mg/dL

Question 18

Eth Gly and Meth characterization

Answer 18

increased anion gap with an osmolal gap of 10+

osmolarity = 2*Na + glu/18 + BUN/2.8

Question 19

Anion Gap Causes

Answer 19

methanol, uric acid, DKA, paraldehyde, iron tox, lactic acid, eth gly, rhabdo, salicylates

Question 20

Non AG Met Acidosis

Answer 20

Renal tube failure
Acetazolamide/Addisons = high K+
GI

Question 21

Delta Gap =

Delta Delta =

Answer 21

Delta Gap = AG-12

Delta Delta = DG + HCO3

Question 22

What do we compare DD to?

if DD 26..

Answer 22

compare to normal Bicarb

26 = holding on to bicarb and there is an additional met alk occuring

Question 23

Alveolar-arterial O2 difference formula
Normal value?
Does it increase with age?
How can we tell if its is normal?

Answer 23

AaO2D = PAO2 – PaO2 (from ABG)
about 10-15 mm Hg
yes
A normal A-a gradient should be less than the (patient’s age divided by 4) + 4.

Question 24

Acidotic =

Acidemia =

Answer 24

Acidotic = final state 
Acidemia = process is still happening but within range

Question 25

intrinsic lung disease has _____ A-a difference

Answer 25

increased. More O2 in lungs because cant get it out due to the disease