acid base

Question 1

resp acidosis

Answer 1

low pH, high CO2, high HCO3

hypoventilation from opiate OD, brainstem injury, vent prob

Question 2

met acidosis - gap

Answer 2

low pH, low CO2, low HCO3
MUDPILES
check anion gap, winters formula: expected pCo2 = 1.5 (HCO3) + 8 +-2
if pCO2 is higher than calculate = with resp acidosis. lack of compensation - maybe need intubation
if lower, with resp alkalosis

Question 3

met acidosis - non gap

Answer 3

low pH, low CO2, low HCO3: low HCO3 is associated with high Cl.
Diahrrea, diurteic (acetazolamide), RTA

Question 4

RTA 1

Answer 4

Distal: can’t excrete H into urine. urine >5.4
Hypo K.
kidney stones
Lithium, ampho B, analgesics, SLE, Sjogren, sickle cell, hepatits
replete K, oral bicarb

Question 5

RTA 2

Answer 5

Proximal: Cant reab HCO3. 
HypoK. 
Osteomalacia
Fanconis, myeloma, amyloid, vit d def
Replete K, mild diuretic.

Question 6

RTA 4

Answer 6

hyperrenin hypoaldo
Hyper K, Hyper Cl
High urine Na wven with salt restriction
Diabetes!
fludrocortisone

Question 7

Resp alkalosis

Answer 7

high ph, low CO2, low HCO3

hyperventilation

Question 8

Metabolic alkalosis

Answer 8

high ph, high CO2, high HCO3
check urine Cl
Cl>20 = ECF expansion, hypertension: hyperaldo. Or normotensive: barters, gittlemens
Cl<20 = ECF contraction. vomiting, ng suction, antacids, diuretics

Question 9

osteomalacia

Answer 9

↑ alk phos, PTH

↓ Ca, phos, urinacy Ca, 25 OH vit D

Question 10

primary hyperthyroid

Answer 10

↑ Ca, ALP, PTH

↓Phos

Question 11

secondary hyperthyroid

Answer 11

↑ Phos, ALP, PTH

↓ Ca