Acid/Base 1 (McCarthy)

Question 1

causes of metabolic alkalosis

Answer 1

antacids
K+ wasting diuretics
decr gastric juices
- vomiting
- nasogastric suctioning

Question 2

metabolic alkalosis: pH/HCO3-

Answer 2

incr pH
incr HCO3-

Question 3

causes of metabolic acidosis

Answer 3

shock
sepsis
diarrhea
renal failure
diabetic ketoacidosis
salicilate OD (aspirin)

Question 4

metabolic acidosis: pH/HCO3-

Answer 4

decr pH
decr HCO3-

Question 5

normal serum pH

Answer 5

7.4 +/- 0.05

Question 6

normal serum [H+]

Answer 6

4.0x10-8 M
or
4.0x10-5 mM

Question 7

small change in pH causes

Answer 7

large change in [H+]

Question 8

main threat to pH mx

Answer 8

physiological acids

Question 9

physiological acids

Answer 9

volatile acid
metabolic intermediates
acidic end-products

Question 10

volatile acid

Answer 10

CO2

Question 11

metabolic intermediates

Answer 11

lactic acid
acetoacetate
beta-hydroxybutyrate

Question 12

ketone bodies

Answer 12

acetoacetate
beta-hydroxybutyrate

Question 13

acidic end products

Answer 13

sulfuric acid
phosphoric acid

Question 14

how much H+ do we produce each day through physiological acids

Answer 14

15,000 mmol H+ per day

Question 15

primary physiological buffer

Answer 15

bicarb buffer

Question 16

buffer

Answer 16

weak acid + conjugate base

Question 17

incr RR will ____ CO2

Answer 17

decr CO2

Question 18

decr CO2 =

Answer 18

respiratory alkalosis
incr pH

Question 19

decr RR will ___ CO2

Answer 19

incr CO2

Question 20

incr CO2 =

Answer 20

respiratory acidosis
decr pH

Question 21

renal compensation

Answer 21

kidney alters [HCO3-] and [H+]

Question 22

renal compensation timeframe

Answer 22

hours to days

Question 23

respiratory compensation

Answer 23

corrects acidosis

Question 24

respiratory compensation timeframe

Answer 24

seconds to mins

Question 25

can compensation normalize serum pH

Answer 25

no - it will not go back to 7.4

Question 26

pH ~

Answer 26

pH ~ [HCO3-]/PCO2

Question 27

aspirin OD (salicylate)

Answer 27

stimulates hyperventilation --> respiratory alkalosis - decr CO2 - incr pH metabolic acidosis - decr HCO3-

Question 28

normal pH

Answer 28

7.4

Question 29

normal PCO2

Answer 29

40

Question 30

normal HCO3-

Answer 30

24

Question 31

normal AG

Answer 31

12

Question 32

Anion Gap (ion gap)

Answer 32

[Na+] - [Cl-] - [HCO3-]

Question 33

anion gap accounts for

Answer 33

misc anions - lactate - ketone - phos/sulf - etc

Question 34

AG > 14

Answer 34

acidosis

Question 35

Acid base algorithm

Answer 35

1. check pH 2. determine metabolic or respiratory 3. calculate AG

Question 36

HCO3- driving pH

Answer 36

metabolic

Question 37

PCO2 driving pH

Answer 37

respiratory

Question 38

causes of AG > 14:

Answer 38

lactic acidosis ketoacidosis toxicity - alcohol - saliylates

Question 39

non-gap acidosis causes

Answer 39

diarrhea - renal/GI changes

Question 40

AG >20

Answer 40

underlying AG metabolic acidosis

Question 41

AG> 20 causes:

Answer 41

Ketoacidosis - starvation Uremia - renal failure Lactic acidosis Toxins - alcohol - salicylates