Acid-Base disorders

Question 1

pH below 7.4 and PCO2 above 40

Answer 1

Respiratory acidosis

Question 2

Causes of respiratory acidosis

Answer 2

Hypoventilation

1) Airway obstruction
2) Acute lung disease
3) Chronic lung disease
4) Opioids, narcotics, sedatives
5) Weakening of respiratory muscles

Question 3

pH below 7.4 and PCO2 below 40

Answer 3

Metabolic acidosis with compensation (hyperventilation)

Question 4

Causes of metabolic acidosis

Answer 4

Check anion gap first: Na - (Cl plus HCO3)

Increased anion gap = MUDPILES

1) Methanol (formic acid)
2) Uremia
3) DKA
4) Paraldehyde or Phenformin
5) Irone tablets or INH
6) Lactic acidosis
7) Ethylene glycol
8) Salicylates

Normal gap (8-12)

1) Diarrhea
2) Glue sniffing
3) RTA
4) Hyperchloremia

Question 5

pH above 7.4 and PCO2 below 40

Answer 5

Respiratory alkalosis

Whenever the arrow is in 2 opposite directions, it’s respiratory

Question 6

Causes of respiratory alkalosis

Answer 6

1) Hyperventilation (early high altitude exposure)

2) Aspiring ingestion (early on)

Question 7

pH above 7.4 and PCO2 above 40

Answer 7

Metabolic alkalosis with compensation (hypoventilation)

Question 8

Causes of metabolic alkalosis

Answer 8

1) Diuretic use
2) Vomiting
3) Antacid use
4) Hyperaldosteronism

Question 9

Tx for methanol OD

Answer 9

Fomepizole

Question 10

Tx for Uremia

Answer 10

Dialysis

Question 11

Tx for DKA

Answer 11

Insulin, fluids

Question 12

Tx for Iron, INH

Answer 12

GI lavage, charcoal (INH)

Question 13

Tx for ethylene glycol

Answer 13

Fomepizole

Question 14

Tx for salicylates

Answer 14

Alkalinize urine