Acid base 2

Question 1

Normal values (4)

Answer 1

pH = 7.4
CO2 = 40
CHO3 = 24
anion gap = 12

Question 2

metabolic acidosis

Answer 2

primary effect is drop in pH and HCO3

Question 3

metabolic alkalosis

Answer 3

primary effect is incr in pH and HCO3

Question 4

resp acidosis

Answer 4

decrease in pH and incr. in CO2

Question 5

resp alkalosis

Answer 5

inrce in pH and dec. in CO2

Question 6

what is metabolic acid/base status determined by

Answer 6

net balance between HCO3- production and loss

Question 7

3 general causes of met acidosis

Answer 7

1. HCO3 loss from buffering
2. NaCO3 loss via diarrhea
3. failure to general HCO3-

Question 8

what is compensatory change for met acid

Answer 8

primary: HCO3 down
compensatory: CO2 down

Question 9

what is compensatory change for met alk

Answer 9

primary: HCO3 up
compensatory: CO2 up

Question 10

what is compensatory change for resp acid

Answer 10

primary: CO2 up
compensatory: HCO3 up

Question 11

what is compensatory change for resp alk

Answer 11

primary: CO2 down
compensatory: HCO3 down

Question 12

does comp. return pH to normal

Answer 12

no, but may return ICF pH to normal

Question 13

what should compensation be for met acid

Answer 13

change in HCO3 = change in CO2

Question 14

2 types of met acidosis

Answer 14

1. anion gap

2. non-anion gap

Question 15

what should be equal in serum

Answer 15

anions and cations

Question 16

what is actually higher

Answer 16

Na always higher

Question 17

what accounts for anion gap

Answer 17

albumin is about a 12 (polyanion)

Question 18

what does increase in anion mean

Answer 18

1. accumulation of anions

2. almost always due to addition of an acid

Question 19

why is anion gap importnant

Answer 19

1. reliable way of telling if met acid is due to addition of acid or loss of bicarb
2. causes of AG are often life threatening
3. can ID met acid even if the blood pH is not acid

Question 20

**4 Causes of AG

Answer 20

1. lactic acidosis
2. ketoacidosis
3. toxins
4. renal failure

Question 21

what is lactic acidosis

Answer 21

from inadequate tissue perfusion - usually shock leads to anarobic resp

Question 22

what is ketoacidosis

Answer 22

lack of insulin leads to fatty acid metabolism - breakdown releases acids

Question 23

3 main toxins

Answer 23

1. methanol - metabolized to formic acid
2. ethylene glycol - car coolant
3. ASA

Question 24

acid in renal failure

Answer 24

very low GFR means retain acids and can’t excrete NH4+

Question 25

which met acid are reversible

Answer 25

lactic and keto - reversible

meth, eth, ASA - no because anions not metabilized

Question 26

what happens in normal AG met acidosis

Answer 26

lose NaHCO3+, so losing both anion (HCO3-) and Cation (Na)

Question 27

2 main causes of normal anion met acid

Answer 27

1. diarrhea - lose bicarb

2. urine excretion

Question 28

treatment of met acid

Answer 28

treat underlying issue

Question 29

**5 steps to acid base prob

Answer 29

1. what is net effect?
2. met or resp
3. is there adequate comp.
   4a. anion gap?
   4b. osmol gap?
4. is there another metabolic process