Acid/Base Disorders

Question 1

What is equation for anion gap?

Answer 1

Anion gap = Na - Cl+ HCO3
Normal is 10-12 mEq/L
elevated anion gap almost always = metabolic acidosis

Question 2

What pH is for acidosis and alkalosis?

Answer 2

Acidosis pH = 7.35
Alkalosis pH = 7.45

Question 3

How do you know when someone is in metabolic acidosis?

Answer 3

PH < 7.35, HCO3 <24

anion gap >16
Causes: MUDPILES = methanol, uremia, diabetic ketoacidosis, paraldehyde, iron overdose, lactic acidosis, ethylene glycol, salicylates

Non anion gap metabolic acidosis = 8-16
Causes: Diarrhea, fistulas, hyperkalemia

When it’s metabolic disorder its always due to the bicarb whether its high or low, low = acidosis, high = alkalosis
When it’s respiratory disorder its always due to the carbon dioxide, low = pCO2 <40 alkalosis, high = pCO2 >40 acidosis

Question 4

How do you know when someone is has metabolic alkalosis?

Answer 4

PH= 7.45, HCO3 >24
Causes: vomiting, loops/ thiazides, antacids, mineralcorticoids excess, hypokalemia, taking excessive bicarb

Question 5

How do you know someone has respiratory acidosis?

Answer 5

PH = 7.35, pCO2 >40
Causes: decreased ventilation (opioids, sleep apnea, COPD, severe asthma, extreme obesity, neuromuscular disorders like MS, Guillai-barre)

Question 6

How do you know when someone has respiratory alkalosis?

Answer 6

Ph = 7.45, pCO2 < 40
Causes: inc ventilation, hyperventilation (anxiety, pain, fevers)