Acid-Base Disorder

Question 1

In what conditions can acute respiratory acidosis be seen? (7)

Answer 1

• Pnuemonia
• Pulmonary oedema
• Opioid overdose
• Sedative drug overdose
• Asphyxiation
• Airway obstruction
• COPD Co2 retention

Question 2

In general what type of failure presents as a respiratory acidosis?

Answer 2

Type 2 resp failure - ventilation and pump failure (hypoventiliation)

Question 3

In what condition can chronic respiratory acidosis be seen?

Answer 3

COPD

Question 4

In what conditions can acute respiratory alkalosis with normal O2 be seen? (6)

Answer 4

• PE
• Panic attack
• Metabolic acidosis response
• Increased metabolic demand e.g fever

Question 5

What type of breathing causes respiratory acidosis?

Answer 5

Hypoventilation

Question 6

What type of breathing causes respiratory alkalosis?

Answer 6

Hyperventilation

Question 7

What does respiratory alkalosis with low O2 indicate?

Answer 7

Response to hypoxia

Question 8

In what conditions can chronic respiratory alkalosis be seen?

Answer 8

Latitude accumulation

Question 9

In what conditions can metabolic acidosis with an increased anion gap be seen? (7)

Answer 9

• Shock
• Diabetic ketoacidosis
• Poisoning
• Sepsis
• Infarction
• Alcohol excess
• Renal failure

Question 10

Give example of poisonings that can cause metabolic acidosis with a normal anion gap (3)

Answer 10

• Aspirin
• Metformin
• Etheylene glycol (antifreeze)

Question 11

In what conditions can metabolic acidosis with a normal anion gap be seen? (4)

Answer 11

• Diarrhoea
• Renal tube acidosis
• Ammonium chloride ingestion
• Adrenal insufficiency

Question 12

In what conditions can metabolic alkalosis be seen? (4)

Answer 12

• Vomiting
• Ka depletion - diuretics
• Cushing’s
• Conn’s

Question 13

What are the two types of acidosis/alkalosis?

Answer 13

• Respiratory

- Metabolic

Question 14

What is metabolic acidosis? (4)

Answer 14

1) pH decrease
2) HCO3- decrease
3) Compensation: PCO2 decrease
4) Lactate increase if increased anion gap

Question 15

What is respiratory acidosis? (3)

Answer 15

1) pH decrease
2) As PCO2 increase
3) Compensation: HCO3- increase

Question 16

What is the difference between acute resp acidosis and chronic resp acidosis?

Answer 16

Acute=small/no HCO3 increase
and pH more decreased
Chronic=Big HCO3 increase and normal pH

Question 17

What indicates acute-on-chronic resp failure e.g COPD exercerbation?

Answer 17

Decrease in pH after compensation

Question 18

What is a simple acid base disorder?

Answer 18

One acid base disorder exhibited by patient

Question 19

What is a mixed acid base disorder?

Answer 19

Two acid base disorders exhibited by patient

Question 20

Give examples of a mixed acid base disorder (2)

Answer 20

• Increased HCO3 and decreased PaCO2

- Decreased HCO3 and increased PaCO2

Question 21

What is metabolic alkalosis? (3)

Answer 21

1) Increased pH
2) Increased HCO3
3) Compensation: increased pCO2

Question 22

What is respiratory alkalosis? (3)

Answer 22

1) Increased pH
2) Decreased PCO2
3) Compensation: increased HCO3

Question 23

What negative ions in the blood balance the positive Na+ charge? (3)

Answer 23

• Bicarb
• Chloride
• Anion gap

Question 24

What is an anion gap? Give 3 examples

Answer 24

Unmeasured ions in patients e.g proteins, phosphate, sulfate

Question 25

What are the two possible responses by the body ions to compensate for bicarb loss?

Answer 25

• Increase chloride ions

- Increase anion gap

Question 26

What are the two types of metabolic acidosis?

Answer 26

• Hypercholeraemic metabolic acidosis

- Increased anion gap metabolic acidosis

Question 27

What is hypercholeraemic metabolic acidosis?

Answer 27

Bicarb loss where chloride has been increased to compensate

Question 28

What is increased anion gap metabolic acidosis?

Answer 28

Bicarb loss where the anion gap has been increased to compensate

Question 29

How is anion gap calculated?

Answer 29

Sodium concentration - (bcarb conc + chloride)