Acid/Base Disorders Flashcards
The urine anion gap should be _____________.
negative; if it’s positive, then something is wrong with the kidneys
For acute and chronic respiratory alkalosis, what should the change in bicarb be?
Acute: 2:10
Chronic: 4:10
For acute and chronic respiratory acidosis, what should the change in bicarb be?
Acute: 1:10
Chronic: 4:10
What are three iatrogenic sources of metabolic alkalosis?
Lactated ringers
Packed RBCs
TPN
Metabolic alkalosis can result from ______-kalemia or vomiting.
hypo
Any state of excess mineralocorticoid can lead to metabolic ___________.
alkalosis (because they stimulate the intercalated cells to secrete H+ and synthesize HCO3)
How do some diuretics cause metabolic alkalosis?
Loop diuretics and thiazides induce increased delivery of sodium to the distal tubule. That then causes increased absorption of sodium at the principal cells. The principal cells therefore generate a gradient that pulls more H+ into the lumen and thus induces more bicarb synthesis.
In response to metabolic alkalosis, how much should pCO2 change?
About 0.7
Why should the urine anion gap be negative in a healthy person?
The equation for ions in the urine should be NH4 + K + Na - Cl, but the urinalysis cannot detect ammonium.
Positive urine anion gap indicates ____________.
renal tubular acidosis
You need to adjust the urine anion gap down by _______ for every 1 mg/dl decrease in serum albumin.
2.5
Metabolic acidosis with a negative urine anion gap indicates ___________.
GI loss of bicarb
How can you tell if a metabolic acidosis is saline responsive?
Urine chloride is less than 20
If the urine is not acidic in a metabolic acidosis, this suggests that ___________ is present.
renal tubular acidosis
If the change in bicarb is less than the change in anion gap, then the patient has ____________.
metabolic alkalosis (even if they also have metabolic acidosis)
