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VETM 442 > Acid Base > Flashcards

Acid Base Flashcards

1
Q

what are the 3 big “pools” of fluid in the body?

A

intracellular fluid, interstitial fluid, and the plasma

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2
Q

what are the four ways the body naturally loses water?

A

feces, urine, sweat, lungs

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3
Q

what does aldosterone respond to, and what does it cause?

A

low blood pressure triggers the RAAS system to release aldosterone which causes renal sodium and water retention to increase blood pressure again

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4
Q

what causes ADH release and what does it do?

A

increase in extracellular osmolarity causes ADH release, which increases thirst and increased water retention

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5
Q

what are the 3 broad ways in which body water can change?

A
  • increase in TBW: excess fluid intake or excessive fluid therapy, maybe inappropriate ADH release
  • decrease in TBW: decrease fluid intake, increase fluid losses (diarrhea or vomiting, sweating, etc)
  • redistribution: from ICF to ECF, increase in hydrostatic pressure or decreased oncotic pressure (think edema), shock, or 3rd space loss
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6
Q

what are some things we use in clinic to assess total body water?

A

clinical signs!!! Hct, TP, USG

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7
Q

____ is the most important osmotically effective solute in the ECF

A

sodium

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8
Q

____ is interpreted in conjugation with patient’s hydration status

A

sodium

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9
Q

what are the 3 types of dehydration in relation to Na+?

A
  • hypernatremic/hypertonic dehydration: mainly losing water
  • normonatremic or isotonic dehydration: equal loss of water and Na+
  • hyponatremic or hypotonic dehydration: mainly losing electrolytes
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10
Q

what are three ways in which you get can a decrease in total body H2O?

A
  • water deprivation/inadequate water intake
  • pure water loss (panting, hyperventilation, diabetes insipidus)
  • water loss moreso than Na loss, osmotic diuresis
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11
Q

what are two ways you can get an increased total body Na+?

A
  • iatrogenic: giving sodium containing IV fluids
  • increased sodium intake without concurrent water intake, salt poisoning
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12
Q

what is the most common rason for a hyponatremia?

A
  • excessive loss with continued water intake:::
  • GI loss (vomitting, diarrhea, sequestration)
  • renal loss (addisons, prolonged diuresis)
  • cutaneous loss (sweating)
  • third space loss (pleural or peritoneal effusion)
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13
Q

what are two other less common reasons for hyponatremia?

A
  • excessive H2O like with edematous disorders like CHF
  • shifting of water from ICF to ECF like with hyperglycemia and a change in osmostic gradient
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14
Q

what are some reasons for a hyperchloremia?

A
  • similar causes to hypernatremia
  • hyperchloremic metabolic acidosis (normal anion gap, alimentary loss of bicarb or renal loss of bicarb)
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15
Q

what is pseudohyperchloremia?

A

when you give KBr and the machine mistakes Br for Cl so it’s essentially a “fake” hyperchloremia

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16
Q

what are some causes for hypochloremia?

A
  • similar causes to hyponatremia
  • hypochloremic metabolic alkalosis (loss or sequestration of Hcl like vomitting, displaced abomasum, GI obstruction, bicarb increases to compensate and maintain eletroneutrality)
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17
Q

is most of K in ICF or ECF?

A

ICF

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18
Q

potassium is regulated via what hormone?

A

aldosterone, promotes renal K excretion

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19
Q

translocation of K+ into cells from ECF to ICF depends on

A

insulin and catecholamines (like epinepherine)

20
Q

what is pesudohyerkalemia?

A

when there is a thrombocytosis and the sample is left out for a long time and the K from the platelets leak into the serum, creating a hyperkalemia that isn’t “true”. OR it can be a breed thing where the RBCs have K that undergo hemolysis and leaks into the plasma as well.

21
Q

what is the most common cause for hyperkalemia?

A
  • decreased renal excretion (renal failure, UT obstruction, addisons disease)
  • rare, but giving potassium rich fluid
22
Q

what are some less common reasons for hyperkalemia?

A
  • shifting from ICF to ECF with tissue necrosis (rhabdo in horses) or diabetes mellitus
23
Q

what are some causes for a hypokalemia?

A

decreased total body potassium like with anorexia, increased renal excretion, GI loss, or cutaneous loss

24
Q

the principle regulators of acid base balance are whom????

A

lungs and kidneys

25
Q

what is the main respiratory acid?

A

CO2

26
Q

hyperventilation causes

A

alkalosis because you’re breathing off more CO2, which increases pH

27
Q

hypoventilation causes

A

slooowww=acidooooosis
retaining CO2, decrease in pH

28
Q

what are the primary acid base disturbances?

A

resp acidosis: increase CO2
resp alkalosis: decrease CO2
met acidosis: decrease bicarb
met alkalosis: increase bicarb

29
Q

what are some causes of hypoventilation/sloooow acidooooosis?

A

pulmonary disease like pneumonia, asthma
anesthesia
CNS depressant drugs

30
Q

what is the compensation for respiratory acidosis?

A

metabolic alkalosis: kidneys will excrete H+ in exchange for Cl- and conserve bicarb

31
Q

what are some causes for hyperventilation?

A

pain, stress/anxiety, extreme exercise, overheating

32
Q

what is the compensation for resp alklalosis?

A

met acidosis: renal excretion of bicarb in exchange fo Cl- and retain H+ ions

33
Q

what are two mechanisms you can get a metabolic acidosis?

A
  • a gain of acid (bicarb titrating out excess acid)
  • true loss of bicarb, diarrhea or kidney loss, etc
34
Q

what are the LUKE acids?

A

lactic acid
uremic acid
ketone
ethylene glycol

35
Q

how do you tell if you have a gain of acid or a true loss of bicarb in regards to a metabolic acidosis?

A

look at the anion gap! if anion gap is increased, it means there is a gain of acids (LUKE), and if it isn’t, it is a true bicarb loss!

36
Q

how do you calculate anion gap?

A

anion gap= (Na + K) - (Cl + HCO3)

37
Q

what are two reasons for a met alkalosis?

A
  • loss of acid/H+ (bicarb not being used up, like with vomiting)
  • gain of bicarb
38
Q

with a disproportionate hypochloremia, why is there an increase in bicarb?

A

because the HCl can’t met up with the bicarb! due to obstruction look at the diagrams idk how to explain it

39
Q

what are the words for increased and decreased blood pH?

A

increased: alkalemia
decreased: acidemia

40
Q

for a blood gas analysis, what kind of sample do you want?

A

an arterial sample, especially when evaluating oxygentation

41
Q

Cl- always needs to be assessed in relation to changes in

A

Na!

42
Q

in regards to Cl- on biochem, what is a proportionate change and what is a disproportionate change?

A

proportionate change: loss or gain of free water or concurrent gain/loss of both electrolytes
disporportionate change: where the change in Cl- is because it is balancing something else out, like when bicarb goes down, chloride goes up and visa versa

43
Q

an ______ is present if SID is decreased
an _____ is present if SID is increased

A

acidosis
alkalosis

44
Q

if SID is more than 35, then
if SID is less than 30, then

A
  • probale alkalosis
  • probable acidosis
45
Q

what is the equation for super quick SID assessment?

A

SID= Na - Cl
only use it to look for presence of an alkalosis on biochem

46
Q

compensation takes how long? metabolic vs respiratory?

A

metabolic: a few days
respiratory: minutes

47
Q

true or false: you cannot have a mixed primary respiratory alkalosis (decrease CO2) and a primary respiratory acidosis concurrently (increase in CO2)

A

true, it is physiologically not possible

VETM 442 (18 decks)

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