Acid-Base Disorders Flashcards
When should you give bicarb in lactic acidosis or ketoacidosis?
if pH
In which types of high anion gap metabolic acidosis should you always give bicarb? (Hint: prevents crossing of blood-brain barrier and urinary loss of toxins.)
ethylene glycol, methanol, and salicylate toxicity
What should be given in ethylene glycol, propylene glycol, and methanol toxicity?
fomepizole (or ethanol)
What causes D-lactic acidosis?
high-carb meal in pt w/ small bowel resection
Causes of high anion-gap metabolic acidosis.
MUDPILES: Methanol Uremia DKA Propylene glycol INH/Iron Lactate Ethylene glycol Salycilates
Causes of non-anion gap metabolic acidosis.
loss of bicarb (diarrhea, RTA type II) or inability of kidneys to excrete hydrogen (RTA types I and IV, mild-mod renal failure)
> 90% of metabolic alkaloses are of this type.
chloride-depletion metabolic alkalosis
What are the causes of chloride depletion metabolic acidosis?
vomiting, NG tube suctioning, and thiazide or loop diuretic use in edematous pts
What is the mechanism of chloride depletion metabolic alkalosis?
the chloridde-bicarbonate exchanger in the distal tubule is suppressed
What should be given to pts w/ metabolic alkalosis from NG suction?
NS
What should be given to edematous pts w/ metabolic alkalosis from thiazides or loop diuretics who don’t respond to stopping the diuretic?
acetazolamide
