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Renal-Genitourinary > Acid-Base > Flashcards

Acid-Base Flashcards

1
Q

what is the acid base mnemonic?

A

ROME

Respiratory
Opposite

Metabolic
Equal

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2
Q

in acid-base disorders, if the opposing value is abnormal and the pH is still abnormal, then _____ ________ has occurred

A

partial compensation

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3
Q

in acid-base disorders, if the opposing value is abnormal and the pH is normal, then _____ ________ has occurred

A

full compensation

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4
Q

what are the symptoms of metabolic acidosis?

A

“KUSSMAUL”

Kussmaul respirations
Urine changes (pH)
Stupor (mental confusion)
Signs of hyperkalemia (muscle twitching)
Malaise
Abdominal pain
Urine output changes
Low blood pressure

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5
Q

what is the initial compensation for metabolic acidosis?

A

hyperventilation to breath off CO2

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6
Q

the difference between the measured cations and anions in the blood

A

anion gap

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7
Q

how to calculate anion gap?

A

Na - (Cl + HCO3)

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8
Q

how to calculate anion gap with normal levels of albumin?

A

albumin x 3

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9
Q

what are 3 endogenous causes of anion gap metabolic acidosis?

A

DLC

Diabetic Ketoacidosis
Lactic acidosis
Chronic Kidney Disease

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10
Q

what are 4 exogenous causes of anion gap metabolic acidosis?

A

MEAT

Methanol poisoning
Ethylene glycol/antifreeze
ASA overdose
Toluene (paint/glue sniffing)

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11
Q

what is the most common cause of non-anion gap metabolic acidosis?

A

type II renal tubular acidosis (proximal)
unable to reabsorb HCO3

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12
Q

what 2 conditions is type I renal tubular acidosis most common in?

A

Sjogren’s
glue/paint sniffing

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13
Q

what is the most common cause of type IV renal tubular acidosis?

A

diabetes mellitus

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14
Q

what causes pancreatitis, panniculitis, polyarthritis, blurred vision and fatigue in metabolic acidosis ?

A

hyperglycemia

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15
Q

what causes CNS abnormalities in metabolic acidosis?

A

ethylene glycol poisoning

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16
Q

what causes retinal edema in metabolic acidosis?

A

methanol intoxication

17
Q

what cause osteoporosis and fractures in metabolic acidosis?

A

CKD

18
Q

what is the general treatment for metabolic acidosis if etiology is unknown and pH < 7.1? (4)

A

IV sodium bicarbonate
dialysis
treat hyperkalemia
consult Nephrology

19
Q

what is the treatment for metabolic acidosis caused by DKA? (4)

A

IV fluids
IV potassium replacement
IV insulin (if K > 3.3)
IV bicarb (if pH < 6.9)

20
Q

what is the treatment for metabolic acidosis caused by lactic acidosis?

A

IV Na bicarbonate

21
Q

what is the treatment for metabolic acidosis caused by salicylate overdose? (3)

A

IV Na bicarbonate
Fluids
Glucose for CNS

22
Q

what is the treatment for metabolic acidosis caused by alcohol overdose? (5)

A

IV/IM thiamine
saline
K+
phosphate
magnesium

23
Q

what is the treatment for metabolic acidosis caused by methanol intoxication? (2)

A

fomepizole +/- dialysis

24
Q

what is the treatment for metabolic acidosis caused by diarrhea?

A

Na bicarbonate

25
Q

what are 2 treatment options for renal tubular acidosis I (distal)?

A

sodium bicarbonate
potassium citrate

26
Q

what are 3 treatment options for renal tubular acidosis II (proximal) that is exogenous?

A

remove offending agent

27
Q

what are 3 treatments for renal tubular acidosis II (proximal) that is caused by fanconi?

A

bicarb
vit D
phosphate replacement

28
Q

what are 3 treatments for renal tubular acidosis IV that is caused by primary adrenal insufficiency?

A

fludrocortisone
saline
loop diuretics
+/- restrict potassium

29
Q

what are the symptoms of metabolic alkalosis?

A

ALKA-LOSIS

Apathy
Loss of potassium (hypokalemia)
Kicking muscle cramps
Anorexia
Light-headedness
Ocular disturbance
Slow respirations (hypoventilation)
Increased neuromuscular excitability
Seizures

30
Q

what is the initial compensation for metabolic alkalosis?

A

hypoventilation to retain CO2

31
Q

most common cause of metabolic alkalosis and characterized by normotensive, dehydration, and hypokalemia

A

saline-responsive metabolic alkalosis

32
Q

cause of metabolic alkalosis characterized by hypertension and edema

A

saline-unresponsive metabolic alkalosis

33
Q

what is the primary saline-unresponsive metabolic alkalosis?

A

hyperaldosteronism (excess mineralocorticoid) due to renal tumor

34
Q

what is the treatment for saline-responsive metabolic alkalosis? (6)

A

IV fluids
IV KCl
acetazolamide OR spironolactone
stop diuretics
stop NG tube suction and add PPI
+/- dialysis

35
Q

what is the treatment for primary saline-unresponsive metabolic alkalosis? (4)

A

remove mineralocorticoid-producing tumor
replete K
replete spironolactone
+/- O2 ventilation

Renal-Genitourinary (7 decks)

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