Acid Base Disorders 1

Question 1

proteins that you eat are broken down into acids or bases?

Answer 1

• acids

Question 2

how does the kidney correct for acidosis?

Answer 2

• H+ excretion

Question 3

lowest urine pH

Answer 3

4.4

Question 4

what urine pH is acidemia

Answer 4

below 5.3

Question 5

highest urine pH

Answer 5

8

Question 6

fruits and vegetable break down will give you acids or bases?

Answer 6

• bases

Question 7

citrate is converted to an acid or base?

Answer 7

• base

- breaks down into bicarbonate

Question 8

in the cortical collecting duct, what is the titratable acid

what is the fixed acid

Answer 8

• H2PO4 (not titrated by our kidneys though)

- NH4 (actually titrated by our kidneys)

Question 9

what are the two things H+ can bind to?

Answer 9

• HPO4

- NH3

Question 10

how can you get metabolic acidosis in the GI tract

Answer 10

• diarrhea

Question 11

how can you get metabolic alkalosis in the GI tract

Answer 11

• vomiting

Question 12

normal compensatory mechanism for metabolic acidosis

Answer 12

• for every 1 decrease in HCO3, PCO2 decreases by 1.2

- winter’s formula

Question 13

what is winter’s formula

Answer 13

expected PCO2 = (1.5xHCO3+8) +/- 2

Question 14

normal compensatory mechanism for metabolic alkalosis

Answer 14

• for every 1 increase in HCO3, PCO2 increases by 0.7

Question 15

normal compensatory mechanism for acute respiratory acidosis

Answer 15

• for every 10 increase in PCO2, HCO3 increases by 1

Question 16

normal compensatory mechanism for chronic respiratory acidosis

Answer 16

• for every 10 increase in PCO2, HCO3 increases by 4

Question 17

normal compensatory mechanism for acute respiratory alkalosis

Answer 17

• for every 10 decrease in PCO2, HCO3 decreases by 2

Question 18

normal compensatory mechanism for chronic respiratory alkalosis

Answer 18

• for every 10 decrease in PCO2, HCO3 decreases by 5

Question 19

two types of metabolic acidosis

Answer 19

• anion gap

- normal anion gap

Question 20

how to calculate anion gap

Answer 20

Na - (Cl+HCO3)

Question 21

differential diagnosis for anion gap metabolic acidosis

which will have an increased osmolal gap)

Answer 21

• Glycols (increased osmolal gap)
• Oxoproline
• L-lactate
• D-lactate
• Methanol poisoning (increased osmolal gap)
• Aspirin toxicity
• Renal failure
• Ketoacidosis

GOLDMARK

Question 22

what is one important symptom of methanol poisoning

Answer 22

• vision changes

Question 23

causes of elevated osmolar gap without metabolic acidosis

Answer 23

• isopropyl alcohol poisoning
• mannitol
• dextran-40
• glycine
• sorbitol

SMIDG

Question 24

differential diagnosis of a normal anion gap metabolic acidosis

which are the most common

Answer 24

• Acute kidney disease
• Chronic kidney disease
• Carbonic anhydrase inhibitors
• Renal tubular acidosis (most common)
• Ureteroenterostomy
• Expansion (volume
• Diarrhea, K-sparing Diuretics (most common)
• ACCRUED

Question 25

if the albumin level is low, what will your anion gap expected normal be

Answer 25

• anion gap expected normal should be lower

Question 26

what is a normal anion gap

Answer 26

• less than 10

Question 27

does compensation ever bring your pH to normal

Answer 27

• no

Question 28

result of aspirin toxicity

Answer 28

• will initially cause respiratory alkalosis and then anion gap metabolic acidosis