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Gen Med Unit 4 > Acid Base > Flashcards

Acid Base Flashcards

1
Q

What is the pH in resp acid?

A

Decreased

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2
Q

What is the PaCO2 in resp acidosis?

A

primary increase in partial pressure of CO2 (pCO2)

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3
Q

What (general) causes resp acidosis?

A

Alveolar hypoventilation

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4
Q

What is a consequence of resp acidosis?

A

CO2 retention in lungs

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5
Q

What are some disorders that lead to resp acidosis?

A
  1. Disorders that reduce pulmonary function and CO2 clearance
    -Primary pulmonary disease:
    COPD
    -Neuromuscular disease:
    Myasthenia gravis
    -Primary CNS dysfunction:
    Brainstem injury
    -Drug induced hypoventilation:
    Opioids
    Methadone
    TCA’s
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6
Q

What are the clinical sxs of resp acidosis?

A
  1. Early
    Headache
    Drowsiness
  2. Late (uncorrected)
    Stupor
    Coma
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7
Q

What are the early lab findings of resp acidosis?

A
  1. Acute CO2 retention:
    increased pCO2
    Minimal change in plasma HCO3
    Serum electrolytes close to normal
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8
Q

What are the lab findings after 2-3 days in resp acidosis?

A

↑ H+ secretion
↑ HCO3 production in distal convoluted tubule
Plasma HCO3 steadily increases

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9
Q

What is the tx for resp acidosis?

A

Underlying disorder must be identified and corrected

Blood pCO2 > 60 mm Hg may indicate need for assisted ventilation if CNS or pulmonary muscle depression is severe

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10
Q

What (generally) causes resp alkalosis?

A

excessive elimination of CO2 from lungs

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11
Q

What is the pH level in resp alkalosis?

A

Increased

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12
Q

What are the Co2 levels in resp alkalosis?

A

Decreased

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13
Q

What are some disorders that cause resp alkalosis?

A
  1. Disorders asst with inappropriately increased resp. rate and increasedCO2 clearance
    -Anxiety/Hyperventilation
    (Most common cause)
    -Salicylate intoxication
    -Hypoxia
    -Primary CNS dysfunction
    -Gram neg septicemia
    -Pregnancy
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14
Q

What are the clinical features of resp. alkalosis?

A 
Hyperventilation
Paresthesias
Lightheadeness
Giddiness
Acute alkalemia may produce tetany like syndrome which is indistinguishable from hypocalcemia
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15
Q

What are the lab findings in acute alkalosis?

A

Increased blood pH

Decreased pCO2

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16
Q

What are the lab findings after a few hours of resp alkalosis?

A
  1. H+ secretion in distal convoluted tubules ↓
  2. Decreased in plasma HCO3
  3. Serum chloride (Cl) level increases
17
Q

What are the treatments for resp alkalosis?

A

Correct underlying disorder
Breath in paper bag
Assisted ventilation may be required

18
Q

What is the pH level in metabolic acidosis?

A

Decreased

19
Q

What is the PaCo2 level in metabolic acidosis?

A

Normal

20
Q

What is the HCO3 level in metabolic acidosis?

A

Decreased.

21
Q

What causes metabolic acidosis through an increased anion gap?

A 
1. Increased anion gap from accumulation of acid:
Lactic acidosis
DKA
Starvation ketosis
Ethylene glycol intoxication
Methanol intoxication
Salicylate intoxication
22
Q

What causes metabolic acidosis through a loss of HCO3?

A

Normal anion gap caused by loss of HCO3:
Diarrhea
Pancreatic drainage
Biliary drainage

23
Q

What are the clinical sxs of metabolic acidosis?

A
  1. Hyperventilation is the earliest and most recognized sign
    Results from stimulation of respiratory drive to blow off CO2
  2. Ventricular arrhythmias may occur
  3. Neurologic complications range from lethargy to coma
24
Q

What are the lab results in metabolic acidosis?

A

Blood pH < 7.35
Decreased plasma HCO3
Decreased pCO2

25
Q

What is the tx for metabolic acidosis?

A
  1. Identify and treat underlying cause
  2. Reg insulin therapy and volume replacement (NS IV) are mainstay of treatment for DKA
  3. HCO3 IV therapy considered if pH < 7.20
    Blood pH should be carefully monitored
    Ongoing acid production may increase HCO3 requirements
26
Q

What can metabolic alkalosis be caused by?

A

Loss of H+
Addition of HCO3 ions
Disproportionate loss of Cl ions

27
Q

What is the pH level in metabolic alkalosis?

A

Increased

28
Q

What is the paCO2 level in metabolic alkalosis?

A

normal

29
Q

What is the HCO3 level in metabolic alkalosis?

A

Increased

30
Q

What are the causes of metabolic alkalosis?

A

Vomiting
NG tube suctioning
Diarrhea
Diuretics

31
Q

What are the neuro sxs of metabolic alkalosis?

A

Paresthesias
Lightheadeness
Carpopedal spasm
Confusion, stupor, coma

32
Q

What are the volume depletion sxs in metabolic alkalosis?

A

Weakness
Muscle cramps
Postural dizziness

33
Q

What are the K+ depletion sxs in metabolic alkalosis?

A

Polyuria
Polydipsia
Muscle weakness

34
Q

What are the lab study results in metabolic alkalosis?

A

pH > 7.45
Increased serum HCO3
increased pCO2 as a result of pulmonary compensation

35
Q

Tx of metabolic alkalosis

A

Increase renal excretion of HCO3

Gen Med Unit 4 (7 decks)

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