Acid/Base Cases

Question 1

Respiratory =

Answer 1

opposite direction arrows bc it compensates the fastest

Question 2

Metabolic =

Answer 2

same direction arrouws bc it compensates a lot slower

Question 3

Anion Gap =

Answer 3

Na - (Cl+HCO3)

Question 4

Elevated anion gap

Answer 4

AT MUD PILES
Alcohol
Toluene
Methanol/Metformin
Uremia
DM ketoacidosis
Paraldehyde
Isoniazide/Iron/Ischemia
Lactic acidosis
Ethylene glycol
Salicylate/Starvation

Question 5

Non-elevated anion gap

Answer 5

USED CAR
Urethral diversion
Saline exogenous
Exogenous acid (HCl)
Diarrhea
Cholestyramine/carbonic anhydrase inhibitors
Addison's disease
Renal tubular acidosis

Question 6

Metabolic acidosis Treatment Options

Answer 6

Consider treating when pH less than 6.9 with sodium bicarbonate or THAM/tromethamine

Question 7

Sodium bicarbonate AE

Answer 7

decrease intracellular pH
Overcorrect alkalosis
Sodium and water overload

Question 8

Tromethamine (THAM) AE

Answer 8

Respiratory depression
Extravasation- inflammation, vascular spasm, necrosis
Hyperkalemia and hypoglycemia
CAUTION IN LIVER OR KIDNEY FAILURE

Question 9

Metabolic Alkalosis

If pH > 7.6 use

Answer 9

HCl

Question 10

HCl AE and pH goal

Answer 10

Use until pH = 7.5
Infusion reaction
Overcorrection –> acidosis

Question 11

Respiratory Acidosis

O2 less than 40 or CO2 > 80 mmHg

Answer 11

Oxygenation

Question 12

COPD Goal O2

Answer 12

88-92%

Question 13

Respiratory alkalosis

pH > 7.6

Answer 13

Mechanical ventilation with analgesia and sedation

Question 14

For an acute change in respiratory acidosis we expect the

Answer 14

HCO3 to go up 1 mEq for every 10 mmHg increase in paCO2 if the patient is compensating appropriately.