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2 - CPR (renal) > Acid - Base Disorders > Flashcards

Acid - Base Disorders Flashcards

1
Q

What is the most important extracellular buffering system?

A

Bicarbonate (HCO3-)

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2
Q

An INCREASE in CO2, will cause what change in the pH?

A

DECREASED pH = Acidosis

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3
Q

A DECREASE in CO2, will cause what change in the pH?

A

INCREASED pH = Alkalosis

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4
Q

An INCREASE in HCO3-, will cause what change in the pH?

A

INCREASED pH = Alkalosis

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5
Q

A DECREASE in HCO3-, will cause what change in the pH?

A

DECREASED pH = Acidosis

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6
Q

What portion of the pH changes does the lungs control?

A

CO2

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7
Q

What portion of the pH changes do the kidneys control?

A

HCO3-

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8
Q

Metabolic Acidosis/Alkalosis involves a change in what?

A

HCO3-

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9
Q

Respiratory Acidosis/Alkalosis involves a change in what?

A

CO2

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10
Q

Metabolic Acidosis

A

DECREASED HCO3-

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11
Q

Metabolic Alkalosis

A

INCREASED HCO3-

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12
Q

Respiratory Acidosis

A

INCREASED CO2

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13
Q

Respiratory Alkalosis

A

DECREASED CO2

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14
Q

What are the 2 types of Metabolic Acidosis?

A

HAGMA – high anion gap

NAGMA – normal anion gap

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15
Q

What are the 2 types of Metabolic Alkalosis?

A

Saline-responsive (hypovolemia)

Non-Saline-responsive (eu/hypervolemia)

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16
Q

If the kidney caused the acidosis/alkalosis, what will compensate?

A

Lung will compensate and vice versa

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17
Q

Describe what compensation should be seen with Metabolic Acidosis

A

LOW HCO3-
–> Means that you have HIGH CO2
–> Increase RR to blow off the CO2
=> Respiratory Alkalosis (LOW CO2)

18
Q

What is the formula to calculate compensation for Metabolic Acidosis?

A

CO2 = 1.5[HCO3-] + 8 +/- 2

19
Q

What is the formula to calculate compensation for Metabolic Alkalosis?

A

PCO2 increases by 0.7 for every 1 mEq/L of HCO3-

20
Q

The appropriate compensation mechanisms by HCO3- for Respiratory Acidosis/Alkalosis change with every _____ change

A

Every 10 mmHg of CO2 change

21
Q

Acute Respiratory Acidosis compensation

A

HCO3 increases by 1

22
Q

Chronic Respiratory Acidosis compensation

A

HCO3 increases by 3.5

23
Q

Acute Respiratory Alkalosis compensation

A

HCO3 decreases by 2

24
Q

Chronic Respiratory Alkalosis compensation

A

HCO3 decreases by 5

25
Q

Normal pH, level of the pH for acidosis/alkalosis

A 
Normal = 7.4
Acidosis = 7.35
Alkalosis = 7.45
26
Q

What is the normal PCO2?

A

40

27
Q

What is the normal HCO3-?

A

24

28
Q

What is the normal Anion Gap?

A

10

29
Q

What is the normal Osmolar Gap?

A

Less than 10

30
Q

What is the formula to calculate Anion Gap?

A

Na - (HCO3 + Cl)

31
Q

What is the formula to calculate Osmolar Gap?

A

Measured serum osmolality - Calculated serum osmolality

32
Q

If the osmolar gap is greater than 10, what does that indicate?

A

Additional solutes are in the blood

33
Q

What is the stepwise approach to these disorders?

A
  1. Determine if acidosis/alkalosis is present
  2. Determine if its respiratory/metabolic
    - - If metabolic acidosis, determine the Anion Gap
    - - If HAGMA, determine the Osmolar Gap
  3. Calculate appropriate compensation
34
Q

What is the stepwise approach for these disorders?

A
  1. Determine if acidosis/alkalosis is present
  2. Determine if its respiratory/metabolic
    - - If metabolic acidosis, calculate the anion gap
    - - If HAGMA, calculate osmolar gap
  3. Calculate appropriate compensation
35
Q

An appropriate compensation is what type of acid base disorder?

A

Simple

36
Q

An inappropriate compensation is what type of acid base disorder?

A

Mixed

37
Q

Acidosis is associated with what levels of K+?

A

Hyperkalemia

38
Q

Alkalosis is associated with what levels of K+?

A

Hypokalemia

39
Q

What is the equation for the Anion Gap and what is its normal value?

A

Na - (HCO3 + Cl)

– should equal 10

40
Q

If HAGMA is present, what should you screen for?

A

Alcohol ingestion

2 - CPR (renal) (27 decks)

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