Acid Base Disorders 1 Flashcards
proteins that you eat are broken down into acids or bases?
- acids
how does the kidney correct for acidosis?
- H+ excretion
lowest urine pH
4.4
what urine pH is acidemia
below 5.3
highest urine pH
8
fruits and vegetable break down will give you acids or bases?
- bases
citrate is converted to an acid or base?
- base
- breaks down into bicarbonate
in the cortical collecting duct, what is the titratable acid
what is the fixed acid
- H2PO4 (not titrated by our kidneys though)
- NH4 (actually titrated by our kidneys)
what are the two things H+ can bind to?
- HPO4
- NH3
how can you get metabolic acidosis in the GI tract
- diarrhea
how can you get metabolic alkalosis in the GI tract
- vomiting
normal compensatory mechanism for metabolic acidosis
- for every 1 decrease in HCO3, PCO2 decreases by 1.2
- winter’s formula
what is winter’s formula
expected PCO2 = (1.5xHCO3+8) +/- 2
normal compensatory mechanism for metabolic alkalosis
- for every 1 increase in HCO3, PCO2 increases by 0.7
normal compensatory mechanism for acute respiratory acidosis
- for every 10 increase in PCO2, HCO3 increases by 1
normal compensatory mechanism for chronic respiratory acidosis
- for every 10 increase in PCO2, HCO3 increases by 4
normal compensatory mechanism for acute respiratory alkalosis
- for every 10 decrease in PCO2, HCO3 decreases by 2
normal compensatory mechanism for chronic respiratory alkalosis
- for every 10 decrease in PCO2, HCO3 decreases by 5
two types of metabolic acidosis
- anion gap
- normal anion gap
how to calculate anion gap
Na - (Cl+HCO3)
differential diagnosis for anion gap metabolic acidosis
which will have an increased osmolal gap)
- Glycols (increased osmolal gap)
- Oxoproline
- L-lactate
- D-lactate
- Methanol poisoning (increased osmolal gap)
- Aspirin toxicity
- Renal failure
- Ketoacidosis
GOLDMARK
what is one important symptom of methanol poisoning
- vision changes
causes of elevated osmolar gap without metabolic acidosis
- isopropyl alcohol poisoning
- mannitol
- dextran-40
- glycine
- sorbitol
SMIDG
differential diagnosis of a normal anion gap metabolic acidosis
which are the most common
- Acute kidney disease
- Chronic kidney disease
- Carbonic anhydrase inhibitors
- Renal tubular acidosis (most common)
- Ureteroenterostomy
- Expansion (volume
- Diarrhea, K-sparing Diuretics (most common)
- ACCRUED
if the albumin level is low, what will your anion gap expected normal be
- anion gap expected normal should be lower
what is a normal anion gap
- less than 10
does compensation ever bring your pH to normal
- no
result of aspirin toxicity
- will initially cause respiratory alkalosis and then anion gap metabolic acidosis
