Acid/Base Disorders Flashcards

1
Q

Rule #1:

A

Look at pH from ABG:

if > 7.40 = primary alkalosis

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2
Q

Rule #2:

A

Calculate anion gap

elevated = primary metabolic acidosis OR mixed acid base problem

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3
Q

Rule #3:

A

If elevated anion gap, calculate osmol gap

(2 x Na) + (Gluc/18) + (BUN/2.8) = 285ish if normal

subtract that value from measured osmolarity

= 10 is normal

abnormal indicates toxin ingestion

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4
Q

Rule #4:

A

Calculate excess anion gap:

calculated AG - 12… add answer to measured bicarb

should = 24-26

low = non-anion gap acidosis

high = underlying metabolic alkalosis

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5
Q

Rule #5:

A

Clinical picture!!

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6
Q

Normal ABG with elevated anion gap= ?

A

metabolic alkalosis AND metabolic anion gap acidosis

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7
Q

Findings of mixed metabolic acidosis and respiratory alkalosis:

A

lower PCO2 than expected for acidosis

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8
Q

Findings of mixed metabolic alkalosis and respiratory acidosis:

A

higher than expected HCO3- for acidosis

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9
Q

Mixed resp and metabolic alkalosis?

A

high bicarb

low PCO2

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10
Q

MUDPILES???

A

DDx for metabolic acidosis

Methanol

Uremia–Cr over 5, BUN over 60

Dka and Aka (EtOH increases osm gap)

Paraldahyde

Iron

Lactic acid

Ethylene glycol

Salicylates

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11
Q

Primary disturbance in metabolic alkalosis:

A

increased plasma HCO3-

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12
Q

Primary disturbance in respiratory acidosis:

A

increased arterial PCO2

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13
Q

Acute compensation for resp acidosis:

A

HCO3- rises 1 mEq for each rise of 10 pCO2

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14
Q

Chronic compensation for resp acidosis:

A

HCO3- rises 3 mEq for each rise of 10 pCO2

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15
Q

Primary disturbance in respiratory alkalosis:

A

decreased arterial CO2

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16
Q

Acute compensation for respiratory alkalosis:

A

HCO3 falls by 2 mEq for each drop of 10 pCO2

17
Q

Chronic compensation for respiratory alkalosis:

A

HCO3 falls by 4 mEq for each drop of 10 pCO2