Acid-Base Disorders

Question 1

Number 1 negative Inotrop

Answer 1

Acidosis

Question 2

how are lab values written?

Answer 2

pH/CO2/O2/HCO3-/BE

Question 3

Hypocapnia?

Answer 3

low CO2

Question 4

Hypercapnia?

Answer 4

High CO2

Question 5

Primary ____ changes bring secondary _____ changes.

Answer 5

CO2, HCO3-

HCO3-, CO2

Question 6

decreased blood pH and HCO3- plasma concentration

-Compensation: decreased CO2 concentration (respiratory response)

Answer 6

Metabolic acidosis

Question 7

Lactate acidosis:

Answer 7

increase in plasma l-lactate

Question 8

Ketoacidosis:

Answer 8

Increased FA production and accumulating ketoacids

Question 9

Alcoholic Ketoacidosis:

Answer 9

poor nutritional status in the setting of abrupt alcohol cessation and or binge drinking

Question 10

ways acid accumulates:

Answer 10

• Ingestion: Methanol, ethylene glycol, alcohol, salicylates

- Renal failure

Question 11

Renal failure:

Answer 11

worsening renal function and fewer nephrons lead to worsening filtration of anions & reduced HCO3⁻ production.

Question 12

2 ways metabolic acidosis happens:

Answer 12

acid build up and bicarbonate loss

Question 13

Bicarbonate loss:

Answer 13

• Diarrhea

- Proximal renal tubular acidosis: impaired reabsorption leads to urinary wasting

Question 14

increased arterial pH and plasma HCO3-

-Compensation: increased PaCO2

Answer 14

Metabolic alkalosis

Question 15

What causes metabolic alkalosis:

Answer 15

• net gain of HCO3- in or net loss of acids from ECF
• often accompanied w/ hypochloremia and hypokalemia
• patients hypoventilate

Question 16

Alkali administration:

Answer 16

HCO3⁻ admin., acetate admin. (HAL), citrate admin. (blood transfusion)

Question 17

Gi metabolic alkalosis:

Answer 17

vomiting and NG aspiration leads to H+ loss

Question 18

Renal metabolic acidosis:

Answer 18

ECF contraction leads to effective HCO3⁻ gain (contraction alkalosis)
Diuretic administration (loop diuretics) common.

Question 19

decreased blood pH and increased CO2

-Compensation: increase in buffering HCO3-

Answer 19

Respiratory acidosis

Question 20

S/s:
Acute: confusion, dyspnea, anxiety
Chronic: daytime somnolence, memory loss, motor disturbances

Answer 20

Hypercapnia, seen with respiratory acidosis.