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Clin Med: GU (block 3) > Acid/Base Disorders > Flashcards

Acid/Base Disorders Flashcards

1
Q

What is normal blood pH?

A

7.35 - 7.45

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2
Q

Describe pulmonary compensation

A

Exhalation of CO2 by the lungs allows a shift of H+ to decr acidity

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3
Q

How is the amount of CO2 exhaled by the lungs regulated?

A

regulated by central & arterial chemoreceptors in response to acidity of blood

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4
Q

Is pulmonary compensation fast or slow and takes how long?

A
  • fast
  • minutes to hours
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5
Q

Describe renal compensation

A

Excretion of H+ by the kidneys in urine will work to decr acidity of blood

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6
Q

How is the amount of H+ excreted by kidneys regulated ?

A

regulated by many mechanisms

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7
Q

Is renal compensation fast or slow & takes how long?

A
  • slower
  • days
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8
Q

Describe the movement of HCO3 in the renal system (nephron)

A

Almost all bicarb is excreted in the glomerulus but then almost completely reabsorbed in the PCT

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9
Q

If either of these compensatory mechanisms fails or becomes overwhelmed, what happens to the pH?

A

the pH in the body becomes abnormal

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10
Q

What causes acidosis?

A

caused by either a fall in HCO3 or elevation in pCO2

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11
Q

What causes alkalosis?

A

caused by either an elevation in serum HCO3 or fall in pCO2

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12
Q

What happens during metabolic acid base disturbance?

A

alteration of serum HCO3 levels

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13
Q

What happens during respiratory acid base disturbance?

A

alteration of CO2 tension (pCO2)

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14
Q

Which acid/base disturbance can be acute or chronic?

A

Respiratory acidosis

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15
Q

Describe Metabolic Acidosis

A

acid accumulates in the blood

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16
Q

Metabolic Acidosis is a result of…

A
  • Excess production of acid
  • Decr excretion of acid
  • Loss of base in urine or stool
17
Q

Metabolic Acidosis causes can be divided into what two groups?

A
  • HAGMA
  • NAGMA
18
Q

What is a normal anion gap?

A

8 - 12

19
Q

Examples of HAGMA
(mudpiles)

A
  • Methanol
  • Uremia
  • Diabetic ketoacidosis
  • Paraldehyde/Propylene glycol
  • Iron/Isoniazid
  • Lactic acidosis
  • Ethanol/Ethylene glycol
  • Salicylates
20
Q

Examples of NAGMA

A
  • Carbonic anhydrase inhibitors (acetazolamide)
  • Adrenal insufficiency
  • RTA
  • Fistula (small bowel or pancreatic)
  • Excess chloride (hyperalimentation or excessive saline administration)
  • Urinary diversion/Ureteroenterostomy
  • Diarrhea
  • Spironolactone
21
Q

Causes of Metabolic Alkalosis
“clever PD”

A
  • Contraction
  • Licorice
  • Endocrine disorder (Conn’s, Bartter’s, Cushing’s)
  • Vomiting
  • Excess alkali
  • Refeeding
  • Post-hypercapnea
  • Diuretics
22
Q

If urine Cl- is high, correcting the underlying dz & supplementing K+ will usually correct…

A
  • Cushing’s
  • Bartter’s
  • Conn’s
23
Q

Respiratory Acidosis is caused by…

A

increase in CO2 tension in blood

24
Q

Respiratory acidosis is a result of…

A
  • Incr CO2 production
  • Decr alveolar ventilation
25
Q

Causes of hypoventilation

A
  • CNS depression (drugs or CVA)
  • Airway obstruction
  • Pneumonia
  • Pulm edema
  • Hemo/Pneumothorax
  • Myopathy
26
Q

Respiratory Acidosis CNS S/S

A
  • Encephalopathy
  • Irritability
  • Inability to concentrate
  • HA
  • Mental cloudiness
  • Combativeness
  • In severe cases, coma
27
Q

Respiratory Acidosis CNS S/S

A
  • Myocardial contractility depression
  • Systemic vasodilatation
  • Pulm & renal vasoconstriction
28
Q

Respiratory Acidosis Tx

A
  • Ensure a patent airway
  • Restore adequate oxygenation
  • Adequate ventilation
  • Reverse/treat underlying cause
29
Q

What is the main cause of respiratory alkalosis?

A

hyperventilation

30
Q

What are some causes of hyperventilation?

A
  • Mechanical ventilation
  • Salicylates
  • Sepsis
  • Pregnancy
  • Anxiety
  • Hypoxia
  • PE
31
Q

Respiratory Alkalosis S/S

A
  • Lightheadedness
  • Paresthesias
  • Cramps
  • Carpopedal spasm
32
Q

Respiratory Alkalosis Tx

A
  • Correct underlying disorder
  • Increasing pCO2 of inspired air (i.e. breathing into paper bag)
33
Q

Describe pH, pCO2, & HCO3 for Metabolic acidosis

A
  • Decr pH
  • Decr pCO2
  • Decr HCO3
34
Q

Describe pH, pCO2, & HCO3 for Metabolic alkalosis

A
  • Incr pH
  • Incr pCO2
  • Incr HCO3
35
Q

Describe pH, pCO2, & HCO3 for Acute respiratory acidosis

A
  • very decr pH
  • Incr pCO2
  • Incr HCO3
36
Q

Describe pH, pCO2, & HCO3 for Chronic respiratory acidosis

A
  • Decr pH
  • Incr pCO2
  • very incr HCO3
37
Q

Describe pH, pCO2, & HCO3 for Respiratory alkalosis

A
  • Incr pH
  • Decr PCO2
  • Decr HCO3
38
Q

Write out chart for Disorder, pH, pCO2, & HCO3

A

DONE

Clin Med: GU (block 3) (7 decks)

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