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Systems 1 Part 2 > ACID-BASE > Flashcards

ACID-BASE Flashcards

1
Q

– ratio that is constant and about equal to 20 to maintain a normal pH

A

bicarbonate to CO2

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2
Q

Respiratory acidosis occurs when –depressing the pH

A

PCO2 rises relative to bicarbonate,

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3
Q

response to respiratory acidosis

A

kidney retains bicarbonate to buffer and excretes more hydrogen ions

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4
Q

dangerous acidosis (significant organ injury)

A

< 7.1

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5
Q

dangerous alkalosis (significant organ injury)

A

> 7.6

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6
Q

normal pH

A

7.4

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7
Q

normal pCO2

A

40

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8
Q

normal bicarbonate

A

24

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9
Q

why is an alteration of PCO2 is always considered the primary process?

A

respiratory compensation is faster than renal compensation

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10
Q

acidosis: high CO2

A

respiratory acidosis

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11
Q

acidosis: low HCO3-

A

metabolic acidosis

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12
Q

respiratory alkalosis

A

low CO2

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13
Q

metabolic alkalosis

A

high HCO3-

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14
Q

anion gap

A

measured cations - measured anions = NA- (chloride and bicarbonate)

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15
Q

normal anion gap

A

12 +/- 4

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16
Q

effect of low albumin to anion gap

A

low anion gap (albumin and other blood proteins = negative charge)

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17
Q

serum anion gap falls – for every 1 g/dL reduction in albumin

A

2.5

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18
Q

methanol

A

anion gap acidoses

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19
Q

uremia

A

anion gap acidoses

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20
Q

diabetic ketoacidosis

A

anion gap acidoses

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21
Q

paraldehyde

A

anion gap acidoses

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22
Q

iron, isoniazid, inhalants

A

anion gap acidoses

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23
Q

lactic acid

A

anion gap acidoses

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24
Q

ethylene glycol, ethanol (alcoholic ketoacidosis)

A

anion gap acidoses

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25
salicylates (aspirin), solvents, starvation (ketoacidosis)
anion gap acidoses
26
most common anion gap acidoses
lactic acid
27
primary mech by which anion gap acidosis occurs
organic acid accumulation
28
hyperalimentation (TPN, IV fluids, excess CL-)
non-anion gap acidosis
29
acetazolamide (carbonic anhydrous inhibitor)
non-anion gap acidosis
30
renal tubular acidosis
non-anion gap acidosis
31
diarrhea
non-anion gap acidosis
32
Addison's disease
non-anion gap acidosis
33
spironolactone
non-anion gap acidosis
34
small bowerl fistulas
non-anion gap acidosis
35
main cause of non-anion gap acidosis
loss of bicarbonate, accumulation of chloride or failure of kidney to excrete acid
36
for every change in 10 in pCO2 --> acutely pH will change by
0.08
37
for every change in 10 in pCO2 --> chronic pH will change by --
0.03
38
acidosis -- in minute ventilation
decrease
39
alkalosis -- in minute ventilation
increase
40
acute acidosis due to --
1. V/Q mismatch due to dead space or shunt | 2. apnea/hypopnea
41
diseases that lead to V/Q mismatch --> acidosis
pneumonia, edema, hemorrhage, mucus plug bronchospasm (asthma, COPD)
42
acute alkalosis due to --
tachypnea (neurogenic, pain, psychogenic)
43
chronic acidosis due to --
hypoventilation syndrome, air trapping (COPD), restrictive lund disease
44
chronic alkalosis is --
rare
45
Winter's formula gives you
expected PCO2 for any given serum bicarbonate
46
Winter's forumla helps determine if the -- is appropriate or inappropriate.
amount of compensation
47
fatal acidosis
pH < 6.9
48
fatal alkalosis
ph > 7.9
49
primary determinant when interpreting acid-base disorder will be --
pCO2
50
pH drop and increased pCO2
acute respiratory acidosis
51
chronic compensated respiratory acidosis
with time, kidney accumulates bicarbonate to normalize (increase pH)
52
pH rise and decreased pCO2
acute respiratory alkalosis
53
why is acute respiratory alkalosis not clinically relevant?
body can't maintain high minute ventilation long enough to keep pCO2 low
54
chronic, compensated respiratory alkalosis by kidney is --
not common
55
acute metabolic acidosis
pH drop, normal pCO2, [HCO3-] drop
56
respiratory compensation for acute metabolic acidosis
pCO2 drops
57
why is respiratory compensation for acute metabolic acidosis not sustainable long term
body can't maintain high minute ventilation (respiratory fatigue limits this)
58
acute metabolic alkalosis
pH rise, normal pCO2, [HCO3-] rise
59
respiratory compensation for acute metabolic alkalosis is clinically uncommon but nevertheless it is --
hyperventilate and reain CO2 which decrease pH
60
most clinical practice
metabolic compensation for chronic respiratory disorders and rapid respiratory compensation for acute metabolic disorders (not sustainable long term)

Systems 1 Part 2 (27 decks)

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