Acid Base Flashcards by Elaina JoAnn

Normal pH

7.35 - 7.45

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normal pCO2

35-45 mm Hg

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normal pO2

75-105 mm Hg

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normal HCO3

22-28 mEq/L

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Anion gap equation

[Na+] - ([Cl-]+[HCO3-])

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Normal anion gap

10-12

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inc. PCO2 –>

respiratory acidosis

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inc. HCO3 –>

metabolic alkalosis

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dec. PCO2 –>

respiratory alkalosis

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dec. HCO3 –>

metabolic acidosis

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Causes of respiratory acidosis

hypoventilation (airway obstruction, lung disease, weak respiratory muscles, opioids)

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Causes of metabolic acidosis

Add H+ –> cause Anion Gap
MUDPILES

Lose Bicarb - normal anion gap acidosis
HARD UP/ASS

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MUDPILES

--> metabolic acidosis (w/ AG)
Methanol
Uremia
DKA
Propylene Glycol
Iron tablets or Isoniazid
Lactic Acidosis
Ethylene glycol
Salicylates (late)

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HARD-ASS

--> metabolic acidosis (w/o AG)
Hyperalimentation
Addison Disease
Renal tubular acidosis
Diarrhea
Acetazolamide
Spironolactone
Saline Infusion

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Causes respiratory alkalosis

Hyperventilation

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Causes metabolic alkalosis

excessive vomiting, diuretics, hyperaldosteronism

pH =  7.40
HCO3 = 23
pCO2 = 40

Normal

pH =  7.50
HCO3 = 35
pCO2 = 42

Alkalosis
High Bicarb –> metabolic
pCO2 normal –> no compensation

Metabolic alkalosis

pH =  7.33
HCO3 = 13
pCO2 = 28

Acidosis
Low bicarb –> metabolic
pCO2 low –> respiratory compensation

Metabolic acidosis w/ respiratory compensation

pH =  7.42
HCO3 = 32
pCO2 = 64

pH normal
High bicarb & High pCO2
High bicarb –> metabolic alkalosis
High pCO2 –> respiratory acidosis

MIXED

REMEMBER: Compensation will never ________

bring pH back to normal

If HCO3 and pCO2 are off, but pH is normal = mixed! Not compensation.

pH =  7.20
HCO3 = 18
pCO2 = 40

pH acidic
Bicarb low –> metabolic
pCO2 ok (no compensation)

metabolic acidosis

pH =  7.20
HCO3 = 24
pCO2 = 54

pH acidic
pCO2 high –> respiratory
bicarb normal –> no compensation

respiratory acidosis

pH =  7.52
HCO3 = 22
pCO2 = 22

pH alkalosis
HCO3 okay
pCO2 low –> respiratory

respiratory alkalosis (note: compensation for this takes a while, no comp here)

``` pH = 7.66 HCO3 = 36 pCO2 = 30 ```

pH alkalosis bicarb high --> respiratory pCO2 low --> metabolic too! mixed: respiratory and metabolic alkalosis

``` pH = 7.47 HCO3 = 14 pCO2 = 22 ```

pH alkalosis bicarb low = compensation pCO2 = respiratory Respiratory alkalosis with metabolic compensation

``` pH = 7.46 HCO3 = 35 pCO2 = 53 ```

pH alkalosis bicarb high = metabolic pCO2 high = respiratory compensation metabolic alkalosis with respiratory compensation

``` pH = 7.39 HCO3 = 12 pCO2 = 22 ```

pH okay bicarb low - metabolic acidosis pCO2 low - respiratory alkalosis MIXED: metabolic acidosis + respiratory alkalosis (NOT compensation d/t normal pH)

``` pH = 7.34 HCO3 = 31 pCO2 = 62 ```

pH acidosis bicarb high = compensation pCO2 high = respiratory respiratory acidosis with metabolic compensation

``` pH = 7.10 HCO3 = 15 pCO2 = 50 ```

pH acidosis bicarb low = metabolic pCO2 high = respiratory MIXED: metabolic and respiratory acidosis

``` pH = 7.24 HCO3 = 24 pCO2 = 53 ```

``` pH = acidosis bicarb = okay pCO2 = high --> respiratory ``` respiratory acidosis

``` pH = 7.58 HCO3 = 34 pCO2 = 28 ```

``` pH = alkalosis bicarb = high --> metabolic pCO2 = low --> respiratory ``` mixed metabolic and respiratory alkalosis

``` pH = 7.23 HCO3 = 19 pCO2 = 38 ```

``` pH = acidosis bicarb = low --> metabolic pCO2 = okay ``` metabolic acidosis

``` pH = 7.33 HCO3 = 30 pCO2 = 58 ```

``` pH = acidosis bicarb = high = compensation pCO2 = high = respiratory ``` respiratory acidosis w/ metabolic compensation

delta gap

anion gap (calculated) - 12 (normal)

starting bicarb

delta gap + measured bicarb Compare to normal Bicarb: If the "starting bicarbonate" is too high, there is a coexistent metabolic alkalosis. If the "starting bicarbonate" is too low, there is a coexistent non- anion gap metabolic acidosis (hyperchloremic metabolic acidosis).