Acid - Base Disorders

Question 1

What is the most important extracellular buffering system?

Answer 1

Bicarbonate (HCO3-)

Question 2

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

Answer 2

DECREASED pH = Acidosis

Question 3

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

Answer 3

INCREASED pH = Alkalosis

Question 4

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

Answer 4

INCREASED pH = Alkalosis

Question 5

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

Answer 5

DECREASED pH = Acidosis

Question 6

What portion of the pH changes does the lungs control?

Answer 6

CO2

Question 7

What portion of the pH changes do the kidneys control?

Answer 7

HCO3-

Question 8

Metabolic Acidosis/Alkalosis involves a change in what?

Answer 8

HCO3-

Question 9

Respiratory Acidosis/Alkalosis involves a change in what?

Answer 9

CO2

Question 10

Metabolic Acidosis

Answer 10

DECREASED HCO3-

Question 11

Metabolic Alkalosis

Answer 11

INCREASED HCO3-

Question 12

Respiratory Acidosis

Answer 12

INCREASED CO2

Question 13

Respiratory Alkalosis

Answer 13

DECREASED CO2

Question 14

What are the 2 types of Metabolic Acidosis?

Answer 14

HAGMA – high anion gap

NAGMA – normal anion gap

Question 15

What are the 2 types of Metabolic Alkalosis?

Answer 15

Saline-responsive (hypovolemia)

Non-Saline-responsive (eu/hypervolemia)

Question 16

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

Answer 16

Lung will compensate and vice versa

Question 17

Describe what compensation should be seen with Metabolic Acidosis

Answer 17

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

Question 18

What is the formula to calculate compensation for Metabolic Acidosis?

Answer 18

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

Question 19

What is the formula to calculate compensation for Metabolic Alkalosis?

Answer 19

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

Question 20

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

Answer 20

Every 10 mmHg of CO2 change

Question 21

Acute Respiratory Acidosis compensation

Answer 21

HCO3 increases by 1

Question 22

Chronic Respiratory Acidosis compensation

Answer 22

HCO3 increases by 3.5

Question 23

Acute Respiratory Alkalosis compensation

Answer 23

HCO3 decreases by 2

Question 24

Chronic Respiratory Alkalosis compensation

Answer 24

HCO3 decreases by 5

Question 25

Normal pH, level of the pH for acidosis/alkalosis

Answer 25

``` Normal = 7.4 Acidosis = 7.35 Alkalosis = 7.45 ```

Question 26

What is the normal PCO2?

Answer 26

40

Question 27

What is the normal HCO3-?

Answer 27

24

Question 28

What is the normal Anion Gap?

Answer 28

10

Question 29

What is the normal Osmolar Gap?

Answer 29

Less than 10

Question 30

What is the formula to calculate Anion Gap?

Answer 30

Na - (HCO3 + Cl)

Question 31

What is the formula to calculate Osmolar Gap?

Answer 31

Measured serum osmolality - Calculated serum osmolality

Question 32

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

Answer 32

Additional solutes are in the blood

Question 33

What is the stepwise approach to these disorders?

Answer 33

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

Question 34

What is the stepwise approach for these disorders?

Answer 34

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

Question 35

An appropriate compensation is what type of acid base disorder?

Answer 35

Simple

Question 36

An inappropriate compensation is what type of acid base disorder?

Answer 36

Mixed

Question 37

Acidosis is associated with what levels of K+?

Answer 37

Hyperkalemia

Question 38

Alkalosis is associated with what levels of K+?

Answer 38

Hypokalemia

Question 39

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

Answer 39

Na - (HCO3 + Cl) | -- should equal 10

Question 40

If HAGMA is present, what should you screen for?

Answer 40

Alcohol ingestion