Acid Base Disorders

Question 1

Definitions and Equations

Answer 1

1. Euphemia - [H+]ECF 40nM/Litre (pH 7.40)
2. Normal - [H+]ECF - 40nM/Litre (pH 7.40)
3. Acidemia - [H+]ECF > 40 (pH < 7.40)
4. Alkalemia - [H+]ECF < 40 (pH > 7.40)

Question 2

H+ Equataion?

Answer 2

H+ = 25 * PCO2 / HCO3

Question 3

Which disorder combination cannot co-exist?

Answer 3

Respiratory Acidosis + Respiratory Alkalosis

Question 4

Metabolic Acidosis - Compensation?

Answer 4

1:1
Immediate !
for every decrease of 1 mmol/Litre in HCO3
there should be a decrease of 1 mmHg PCO2

Question 5

Metabolic Acidosis - Anion Gap ?

Answer 5

[Na+] - ([Cl-] + [HCO3-])

Question 6

Why the compensation “tries” to restore the H+ (pH) toward normal, but never quite makes it?

Answer 6

It corrects the internal cells pH, and the the Extra cellular fluid pH

Question 7

Anion Gap type Metabolic Acidosis? (4)

Answer 7

Anion Gap > 12:

1. Ketoacidosis
2. Lactic
3. Uremic
4. Poisons

Question 8

Anion Gap type Metabolic Acidosis - Poisons

Answer 8

1. Methanol
2. Ethylene glycol
3. Salicylic acid
4. Other

Question 9

Anion Gap type Metabolic Acidosis - Ketoacidosis? (3)

Answer 9

1. Diabetic
2. Lactic
3. Starvation

Question 10

Anion Gap type Metabolic Acidosis - Lactic? (2)

Answer 10

1. Type A (ischemia, anoxia)

2. Type B (metabolic)

Question 11

Anion Gap type Metabolic Acidosis - Uremic? (0)

Answer 11

None

Question 12

Non-Anion Gap Metabolic Acidosis

Answer 12

Rare: HCl poisoning
Primary loss of HCO3- :
1. renal - complicated
2. external (diarrhea, uretero-sigmoidostomy)