Acid-Base Disorders Flashcards
How is blood pH maintained?
Extracellular and intracellular buffers
Rate of alveolar ventilation
Renal excretion of H+
What sample would be good for evaluating acid base status?
Venous
What sample should you use to evaluate pO2 and is useful for evaluating cardiopulmonary function
Arterial
Blood grass analysis is collected in what tube?
Green (heparin)
TCO2 = _____________
Bicarb!!!
Increased blood pH
Alkalemia
Decreased blood pH
Acidemia
Is pCO2 an acid or base?
ACID
Is pCO2 is increased you have?
Respiratory acidosis
If pCO2 is decreased you have a ??
Respiratory alkalosis
Is TCO2 an acid or base?
BASE
TCO2=HCO3-
If HCO3- is increased you have
Metabolic alkalosis
If HCO3- is decreased you have??
Metabolic acidosis
If you have an increased pCO2 you have ______________ and would compensate with by __________
Respiratory acidosis; increased HCO3- (metabolic alkalosis)
If you have a decreased in HCO3- you have a _______________ and would compensate by?
Metabolic acidosis; decreasing PCO2 (metabolic alkalosis)
If you have decreased pCO2 you have a ____________ and would compensate by?
Respiratory alkalosis; decrease HCO3- (metabolic acidosis)
If you have increased HCO3- you have a _______________ and would compensate by??
Metabolic alkalosis; increase pCO2 (respiratory acidosis)
What leads to a respiratory acidosis?
Hypoventilation
- anesthesia
- diffuse pulmonary disease
- intra-thoracic lesions
- CNS disease
What leads to respiratory alkalosis ?
Hyperventilation
- hypoxemia
- pain/anxiety
- hyperthermia
- drugs stimulating respiratory center
What two mechanisms can result in a metabolic acidosis?
Increase ACID
Loss of BASE (bicarb)
Metabolic acidosis with high anion-gap, what is the cause?
Increase in non-volatile acids (KLUE)
Ketone
Lactate
Uremic acids
Ethylene glycol (toxins)
Where is BICARB lost, leading to acidosis?
GI -diarrhea
Intestinal ileus
Salivation (ruminants)- choke
Urinary loss
What is the long term compensation for metabolic acidosis?
Increased renal excretion of H+
What are the two mechanisms that result in a metabolic alkalosis?
Increase in BASE
loss of ACID
What are causes of a hypochloremic metabolic alkalosis in monogastric animals?
Severe gastric vomiting
Pyloric outflow obstruction
What are causes of a hypochloremic metabolic alkalosis in ruminants?
Sequestration of fluid in abomasum
- ileus
- abomasal displacement
What are causes of excessive renal loss of H+?
Diuretics
Hypokalemia
-stimulate H+K+ATPase pump-> K+retention and H+secretion -> HCO3- generation
Chronic respiratory acidosis
What is the long term compensation for a metabolic alkalosis?
Increased renal retention of H+
When should you look for mixed acid-base disturbances?
Animal with electrolyte disturbances
Animal with a disease associated with acid-base disturbance, but has normal blood gas values
Compensatory response is moving in wrong direction
PH (7.20-7.40) 7.1 L
PCO2 (28-50) 52 H
HCO3 (16-23) 20
Classify the primary acid base disorder
Respiratory acidosis
PH (7.20-7.40) 7.42 H
PCO2 (28-50) 30
HCO3 (16-23) 28 H
Classify the primary acid base disorder
Metabolic alkalosis
PH (7.20-7.40) 7.43 H
PCO2 (28-50) 22 L
HCO3 (16-23) 20
Classify the primary acid base disorder
Respiratory alkalosis
PH (7.20-7.40) 7.18 L
PCO2 (28-50) 45
HCO3 (16-23) 12 L
Classify the primary acid base disorder
Metabolic acidosis
PH (7.20-7.40) 7.17 L
PCO2 (28-50) 25 L
HCO3 (16-23) 10 L
Classify the primary acid base disorder
Metabolic acidosis
PH (7.20-7.40) 7.17 L
PCO2 (28-50) 25 L
HCO3 (16-23) 10 L
Classify the compensatory acid base disorder
Respiratory alkalosis (hyperventilation)
PH (7.20-7.40) 7.48 H
PCO2 (28-50) 58 H
HCO3 (16-23) 30 H
Classify the primary acid base disorder
Metabolic alkalosis
PH (7.20-7.40) 7.48 H
PCO2 (28-50)58 H
HCO3 (16-23) 30 H
Classify the compensatory acid base disorder
Respiratory acidosis (Hypoventilation)
PH (7.20-7.40) 7.14 L
PCO2 (28-50) 56 H
HCO3 (16-23) 10 L
Classify the primary acid base disorder
Respiratory acidosis AND metabolic acidosis
Mixed acid-base disorder
PH (7.20-7.40) 7.44 H
PCO2 (28-50) 22 L
HCO3 (16-23) 10 L
Classify the primary acid base disorder
Respiratory alkalosis
How should you evaluate acid-base disturbances on a chemistry?
- TCO2 (bicarb)
- > high- selective chloride loss
- > low - acidosis, check anion gap - Anion cap
- > increase - metabolic acidosis (KLUE) - Selective chloride loss
- > yes - metabolic alkalosis
Na (148-157) 161 H K (3.5-5.1) 4.4 Cl. (115-128). 113 L TCO2 (16-25) 30 H AG. (15-25). 19
Based on TCO2, what A/B disorder is present?
Metabolic alkalosis
Na (148-157) 161 H K (3.5-5.1) 4.4 Cl. (115-128). 113 L TCO2 (16-25) 30 H AG. (15-25). 19
Is there selective chloride loss?
Yes
Na (148-157) 161 H K (3.5-5.1) 4.4 Cl. (115-128). 113 L TCO2 (16-25) 30 H AG. (15-25). 19
Based on AG, this there a titrational metabolic acidosis?
Nope
Na (148-157) 161 H K (3.5-5.1) 4.4 Cl. (115-128). 113 L TCO2 (16-25) 30 H AG. (15-25). 19
What acid-base disturbance is this?
Metabolic alkalosis due to selective chloride loss
Na (148-157) 134 L K (3.5-5.1) 5.0 Cl. (115-128). 95 L TCO2 (16-25) 7.0 L AG. (15-25). 37
Based on TCO2, what A/B disorder is present?
Metabolic acidosis
Na (148-157) 134 L K (3.5-5.1) 5.0 Cl. (115-128). 95 L TCO2 (16-25) 7.0 L AG. (15-25). 37
Is there selective chloride loss?
Yes
Na (148-157) 134 L K (3.5-5.1) 5.0 Cl. (115-128). 95 L TCO2 (16-25) 7.0 L AG. (15-25). 37
Based on the AG, is there a titrational metabolic acidosis?
Yes
Na (148-157) 134 L K (3.5-5.1) 5.0 Cl. (115-128). 95 L TCO2 (16-25) 7.0 L AG. (15-25). 37
What acid-base disturbances are present ?
Metabolic acidosis use to increased anion gap
AND
Metabolic alkalosis due to selective chloride loss
Which clinical sign may be associated with metabolic alkalosis ?
Vomiting
Diarrhea
Hyperventilation
Hypoventilation
Vomiting
Which clinical sign may be associated with metabolic acidosis ?
Vomiting
Diarrhea
Hyperventilation
Hypoventilation
Diarrhea
Which clinical sign may be associated with respiratory alkalosis ?
Vomiting
Diarrhea
Hyperventilation
Hypoventilation
Hyperventilation
Which clinical sign may be associated with respiratory acidosis ?
Vomiting
Diarrhea
Hyperventilation
Hypoventilation
Hypoventilation