Acid Base Disease Flashcards
What is the Chemical equation for the Bicarbonate Buffer?
H + HCO3 H2CO3 H2O + CO2
What is the pH range compatible with life?
Tightly held at 7.40
range compatible with life is 6.80 to 7.80
H+ is inversely related to pH
what is the definition of Acidosis and Alkalosis?
Acidosis: pH 7.45
What is the Physiologic Change associated with Metabolic Alkalosis?
Increased HCO3
What is the Physiologic Change associated with Metabolic Acidosis?
Decreased HCO3
What is the Normal level of Bicarbonate?
25 mmol/L
What Bicarb level equates to Metabolic Alkalosis?
> 40 mmol/L
What condition maintains metabolic Alkalosis?
Condition resulting in inability to secrete HCO3 by the kidneys
What are causes of Metabolic Alkalosis?
GI Hydrogen loss: Vomiting/NG Renal Hydrogen loss -1^ Aldosteronism -Loop or thiazide diuretics IC Shift of hydrogen Alkali administration Contraction alkalosis -Massive Diuresis
How is Contraction alkalosis Caused and Maintained?
Cause: Diuretics- secretion of H+ and K+ with vol loss
Maint: Hyperaldosterone- Counteractis hypovolemiaand promotes Na/Water/bicarb retension and K/H secretion
What is the Tx of Metabolic Alkalosis?
Correct underlying cause: Stop NG suction and Diuretics
AND Maintainers
CORRECT Electrolyte Abn. Requires NaCl or KCl fluid resuscitation
Acetazolamide
What bicarb level is associated with Metabolic acidosis?
Bicarb
What is the equation for anion gap?
[Na]- ([Cl] + [HCO3])
What are the unmeasured ions?
SO4, PO4, organic acids, intoxicants and their metabolites
What are rhe measured anions?
Na+, Cl- and HCO3-
What is a normal Anion Gap?
8-10 +/- 2
USE 12mmol/L while calculating
What will increase anion gap?
Increase in unmeasured ions
What are rhe measured cations?
Ca++, K+, Mg+
What are the causes of High AG Metabolic Acidosis?
MUDPILES Methanol Uremia DKA * Propylene glycol Infection, Iron, Isoniazid Ethylene glycol Salicylates
What is the triad of DKA?
Hyperglycemia
High AG metabolic Acidosis
Ketonemia
What are the common causes of Increased Serum osmolal Gap?
Methanol intox
Ethylene glycol intox
What is Methanol Metabolized to? S and S?
Formaldehyde/formic acid
CNS/retinal injury/ pancreatitis
What is Ethylene glycol metabolized to? S and S?
Oxylate, hippurate
Neuro/Cardiopulm collapse/Ca oxalate crystals in urine
What are the early S and S of Aspirin intoxication?
Tinnitus, vertigo, N/V/D
What are the Acid Base effects of ASA intox?
Initial: Resp Alkalosis
Later: High AG metabolic Acidosis
Net: Mixed: Resp alkalosis AND Metabolic Acidosis
What is the Tx of ASA Intox
Activated Chatrcoal
BICARBONATE
monitor serum ASA conc
>100 mg/dL ABSOLUTE INDICATION FOR HEMODIALYSIS
