Acid Base Flashcards
Winters Formula for what? formula?
expected PCO2 in metabolic acidosis/1.5(Hco3) + 8+/-2
correct of AGAP for albumin?
every decrease in 1 of albumin (normal being 4), AGAP increases by 2
Delta GAP=
AG-12
Delta GAP + Serum hco3=
starting bicarb
starting bicarb range?
<22- >26, either additional non gap acidosis or additional metabolic alkalosis
AGAP causes?
methanol, propylene glycol, ethylene glycol, Pyroglutamic acid(tylenol), isoniazid
Type B lactic acidosis causes?
Linezolid, Propofol, Metformin
toxic alcohol that does not cause AGAP?
isopropyl alcohol
fomepizole MOA?
inhibits lactate dehydrogenase
3 causes of normal anion gap acidosis?
RTA, GI loss, ileal conduit
Urine anion GAP=
(Na+K)-Cl
negative Ugap, high Ucl=
GI tract loss
positive Ugap, low Ucl=
renal dysfunction(RTA)
Type 1 RTA location? normal mechanism distal tubule?
distal/normally excretes H+
Type 1 RTA urine pH?
> 5.5
Type 1 RTA potassium?
hypokalemia
other signs of RTA type 1?
stones, high urine pH, hypokalemia
Type 1 RTA treatment?
bicarbonate
Type II RTA location? mechanism?
PCT/cannot reabsorb Hco3
Type II RTA potassium?
hypokalemia like Type 1(secondary hyperaldosteronism)
Type II urine pH?
<5.5 bc the distal tubule is working and acidifying urine
Type II RTA treatment?
no point in giving bicarb because it wont be reasborbed. give diuretics to induce a contraction alkalosis
Type 1 RTA causes?
Sjogrens, SLE, hashimoto, ampho B, nephrocalcinosis
Type IV RTA mechanism?
Hypoaldosteronism
Type IV RTA potassium?
hyperkalemia (only one)
Type IV RTA causes?
DM, HIV, sickle cell
ileal conduit treatment?
bicarbonate
Metabolic alkalosis with high BP, high urine Na and Cl?
Conns syndrome
Met alk with normal 3rd space, low urine chloride?
Saline responsive- vomiting, NGT,
Met alk with normal 3rd space, high urine Cl?
Low K, low mag, Bartter, Gitelman
Gitelman syndrome age? electrolytes?
hypomag, hypoK, older age
Bartter syndrome different from Gitelman?
younger age with failure to thrive
calculated osmolarity
2Na+BUN/2.8+ gluc/18
causes of negative anion gap?
lithium and paraproteins
5 oxoproline is what and can cause what?
pyroglutamic acid seen in tylenol use, can cause a high AGAP acidosis
OTC deficiency, what is it? what are consequences? tx?
urea cycle disorder/ hyperammonemia/ lactulose and rifaximin and sodium benzoate
tox alcohol that does not cause acidosis?
isopropyl alcohol
why do aloholics get a AGAP acidois?
ketone body producting from starvation and increased lipolysis
winters formula? expected PCO2 in metabolic acidosis
1.5x bicarb +8 +-2
how does acteaminophen OD cause AGAP acidosis?
buildup of 5 oxoproline, and the treatment is NAC
how do diuretics cause alkalosis?
secretion of hydrogen ions by the H/K ATPase pump
how do loop diuretics work?
blocking the Na/K/CL co transporters in the thick ascending limb
how does diuril work?
inhibitis NaCl absorption n the distal tubules
difference between alcholic ketoacidosis and DKA?
Gluc<250 alcohol
very high ketones and high BHB in dka
