Acid Base Flashcards
How can you tell that compensation is adequate?
Within 3mEq/L HCO3- or 3 mmHg CO2 of the expected value
TCO2
Bicarb (base)
pCO2
CO2 (acid)
What loss can cause a metabolic alkalosis?
Loss of H+ and Cl- rich fluid
Gastric vomiting, GI obstruction, Displaced abomasum, Sweating
Hypochloremic metabolic alkalosis with Paradoxic Aciduria mechanism
Occurs with sequestration of Cl- and H+ (usually in cows with displaced abomasum or excessive sweating in horses)
- Because Cl- and H+ are low, bicarb increases (remember Cl- and bicarb levels are inversely related because they are both negative)
- Increased bicarb creates alkalosis
- More Na in blood is presented to distal tubules (usually the animals are dehydrated, activating RAAS)
- Na reabsorption is coupled to either K+ or H+, so in order for the body to retain Na, it would have to excrete K+ or H+
- To conserve K+, the body excretes H+ instead. Resulting in acid urine.
Hyperventilation causes
Respiratory alkalosis
Hypoventilation causes
Respiratory acidosis
What can cause loss of HCO3-? (leading to metabolic acidosis)
Diarrhea
Addison’s disease
What can cause the addition of acids? (leading to metabolic acidosis)
Ketoacidosis
Lactic acidosis
Ethylene glycol
Renal failure
Two types of metabolic acidosis
Titrational acidosis
Secretional acidosis
Titrational acidosis
Increased organic acids (bicarb is used up)
Anion gap will be increased
Secretional acidosis
Loss of bicarb
Anion gap will be normal (body will conserve Cl-)
Anion gap formula
(Na + K) - (Cl + HCO3)
What can cause an increased anion gap (titrational) metabolic acidosis?
Excess: Ketones Lactic acid Sulfates Phosphates Uremic acids Ethylene glycol metabolites
What type of anion gap is seen with hypoalbuminemia?
Low anion gap
