Acid Base Disorders

Question 1

Causes of acute respiratory acidosis

Answer 1

1. Respiratory pathophysiology - airway obstruction, severe pneumonia, chest trauma/pneumothorax
2. Acute drug intoxication (narcotics, sedatives)
3. Residual neuromuscular blockade
   CNS disease (head trauma).

Question 2

Causes of chronic respiratory acidosis

Answer 2

Chronic lung disease (BPD, COPD)
Neuromuscular disease
Extreme obesity
Chest wall deformity

Question 3

Causes of respiratory alkalosis

Answer 3

Pain
Anxiety
Hypoxemia
Restrictive lung disease
Severe congestive heart failure
Pulmonary emboli
Drugs
Sepsis
Fever
Thyrotoxicosis
Pregnancy
Overaggressive mechanical ventilation
Hepatic failure

Question 4

Causes of metabolic acidosis with normal anion gap

Answer 4

Renal tubular acidosis (RTA).
Post respiratory alkalosis
Hypoaldosteronism
Potassium sparing diuretics
Pancreatic loss of bicarbonate
Diarrhea
Carbonic anhydrase inhibitors
Acid administration (HCI, NH4CI, arginine HCI) Sulfamylon Cholestyramine
Ureteral diversions

Question 5

Causes of metabolic acidosis with elevated anion gap

Answer 5

Ketoacidosis - diabetic, alcoholic, starvation
Lactic acidosis - hypoxia, shock, sepsis, seizures
Toxic ingestion - salicylates, methanol, ethylene glycol, ethanol, is alcohol, paraldehyde, toluene
Renal failure - uremia