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Boards.CP.Chemistry > Acid/Base Disorders > Flashcards

Acid/Base Disorders Flashcards

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1
Q

Acidemia definition.

A

pH <7.35

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2
Q

Alkalemia definition.

A

pH >7.45

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3
Q

Acidosis definition.

A

Condition tending to LOWER pH

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4
Q

Alkalosis definition.

A

Condition tending the RAISE pH

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5
Q

Respiratory Acidosis:

  • Hypo/Hyperventilation
  • Primary change
  • Compensation
A
  • Hypoventilation (insufficient elimination of CO2)
  • CO2
  • Altered renal handling of HCO3-
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6
Q

Respiratory Alkalosis:

  • Hypo/Hyperventilation
  • Primary change
  • Compensation
A
  • Hyperventilation (excess elimination of CO2)
  • CO2
  • Altered renal handling of HC03-
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7
Q

Metabolic Acidosis/Alkalosis:

  • Cause
  • Primary Change
  • Compensation
A
  • Excessive intake of, excessive production of, or too little renal elimination of an acid or a base
  • Bicarbonate (HCO3-)
  • Alteration in pulmonary handling of CO2
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8
Q

Henderson-Hasselbalch Equation.

-normal individual

A

pH=pKa+log(base/acid)

pH=6.1+log(bicarb/[0.03xPaCO2])

pH=7.4
pKa=6.1
Base(Bicarbonate;HCO3-)=24 mol/L
Acid(Carbonic Acid;H2CO3)=0.03xPaCO2
- 0.03x40mmHg= 1.2 mol/L

Thus:
pH=6.1+log(bicarb/[0.03xPaCO2])

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9
Q

Metabolic Acidosis:

  • pH and HCO3 (same/opposite)
  • HCO3 is usually what?
A
  • Same Direction (both Decreased)

- HCO3 is usually 25 mEq/L

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10
Q

Respiratory Acidosis:

  • pH and HCO3 (same/opposite)
  • pCO2 is usually what?
A

Opposite Direction

  • pH Decreased
  • HCO3 increased

pCO2 is usually >44 mmHg

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11
Q

Metabolic Alkalosis:

  • pH and HCO3 (same/opposite)
  • bicarb is usually what?
A
  • Same Direction (both Increased)

- HCO3 usually >25 mEq/L

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12
Q

Respiratory Alkalosis:

  • pH and HCO3 (same/opposite)
  • pCO2 is usually what?
A

Opposite direction

  • pH Increased
  • HCO3 Decreased

pCO2 is usually 40 mmHg

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13
Q

Determination if the compensation is appropriate:

-Metabolic Acidosis

A

For each 1.3 mEq fall in HCO3

-pCO2 decreases by 1.0 mmHg

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14
Q

Determination if the compensation is appropriate:

-Metabolic Alkalosis

A

For each 0.6 mEq rise in HCO3

-pCO2 increases by 1.0 mmHg

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15
Q

Determination if the compensation is appropriate:

-Acute Respiratory Acidosis/Alkalosis

A

For each 1 mmHg change in pCO2

-HCO3 changes by 0.1 in the same direction

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16
Q

Determination if the compensation is appropriate:

-Chronic Respiratory Acidosis/Alkalosis

A

For each 1 mmHg change in pCO2

-HCO3 changes by 0.4 in the same direction

17
Q

Anion Gap calculation.

A

= [Na]-(Cl+HCO3)

Normal 10-14

18
Q

What is often elevated in Nonanion Gap Acidosis?

A

Chloride (hyperchloremic metabolic acidosis)

19
Q

When might you see a low anion gap?

A
  • Hypoalbuminemia

- Paraproteinemia

20
Q

Osmolal gap formula.

A

=Osm(measured)-(2[Na]+[Glucose]/18+[BUN]/2.8)

Normal <10

21
Q

How are metabolic alkalosis categorized?

A

Chloride Responsiveness (Ucl<10) or Resistance (Ucl>10)

22
Q

Metabolic Alkalosis:

-Chloride Responsive (Ucl<10). (6)

A
  • Diuretics
  • Vomiting
  • NG tube suction
  • Villous Adenoma
  • Carbenicillin
  • Contraction Alkalosis
23
Q

Metabolic Alkalosis:

-Chloride Resistant (Ucl>10). (6)

A
  • Hyperaldosteronism
  • Cushing syndrome
  • Exogenous Steroids
  • Licorice (glycyrrhizin)
  • Bartter syndrome
  • Milk-Alkali syndrome
24
Q

Respiratory Acidosis results from what?

A

Impairment of ventilation

25
Q

Respiratory Alkalosis results from what?

A

Hypoxemia, in which compensatory hyperventilation leads to hypocapnea

26
Q

Metabolic Acidosis with Increased Anion Gap (>12)

A
  • Methanol
  • Uremia
  • Ketoacidosis
  • Paraldehyde
  • Lactic Acidosis
  • Ethylene Glycol
  • Salicylate
27
Q

Metabolic Acidosis with Normal Anion gap (<12)

A
  • Diarrhea
  • Recovery phase DKA
  • Ureterosigmoidostomy
  • NH4Cl
  • Carbonic Anhydrase Inhibitors
  • Total parenteral nutrtion
  • Renal Tubular Acidosis
28
Q

Metabolic Acidosis with Increased Osmolal Gap.

A
  • Methanol
  • Propylene glycol
  • Ethylene glycol
  • Paraldehyde
  • Ethanol (sometimes)
29
Q

Metabolic Acidosis with normal Osmolal Gap.

A
  • Isoproanol
  • Glycerol
  • Sorbitol
  • Mannitol
  • Acetone
  • Ethanol (sometimes)

Boards.CP.Chemistry (17 decks)

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