Acid Base Disorders CIS

Question 1

ventilation

Answer 1

gas gets to alveoli

Question 2

minute ventilation

Answer 2

RR x TV

Question 3

henderson hasselbach

Answer 3

pH = 6.1 + log(HCO3) / 0.03 x pCO2

Question 4

primary acid base disorder

Answer 4

pathologic process

Question 5

secondary acid base disorder

Answer 5

normal physiologic compensation to primary disorder

Question 6

high anion gap metabolic acidosis

Answer 6

look at MUDPILES causes

Question 7

normal anion gap metabolic acidosis

Answer 7

look at extra-renal loss (diarrhea)

-or renal loss (RTA)

Question 8

causes of respiratory acidosis

Answer 8

hypoventilation

• drugs decreased resp drive
• decreased tidal volume anatomically

Question 9

anion gap

Answer 9

Na - HCO3 - Cl

normal = 10

Question 10

MUDPILES

Answer 10

methanol
uremia (ESRD)
diabetic ketoacidosis
paraldehyde
infection, iron, isoniazide
lactic acidosis
ethylene glycol, alcohol
salicylates, starvation

Question 11

uremic acidosis

Answer 11

severe renal function decrease

Question 12

lactic acidosis

Answer 12

metformin
HIV meds
isoniazide
liver failure
seizures
sepsis
ischemia

Question 13

diabetic ketoacidosis

Answer 13

more often DM I

-lipolysis - fatty acide to liver - ketones - acidosis

Question 14

osmolar gap

Answer 14

2xNa + glucose/18 + BUN/2.8

normal less than 10

Question 15

alcoholic ketoacidosis osmolar gap**

Answer 15

OG = ethanol /4.6

if not, look other alcohols
-ethylene glycol, methanol

Question 16

tinnitus

Answer 16

ear ringing

-salicylate poisoning

Question 17

causes of normal AG metabolic acidosis

Answer 17

diarrhea
decreased HCO3 reabsorption
increased anion intake
large NaCl (expansion acidosis)

Question 18

contraction

Answer 18

alkalosis

Question 19

expansion

Answer 19

acidosis

Question 20

RTA type I

Answer 20

distal

• decreased H secretion
• alkaline urine**
• risk of stone formation
• hypokalemia

Question 21

RTA type II

Answer 21

proximal

• defect bicarb reabsorption prox tub
• elevated urine bicarb
• low urine pH**
• hypokalemia

Question 22

RTA type IV

Answer 22

distal hyperkalemic

• chronic renal failure
• insufficient aldosterone production or resistance
• hyperkalemia**

Question 23

urinary anion gap

Answer 23

Na + K - Cl

negative - extrarenal loss (high NH4)
positive - renal loss (low NH4)

Question 24

metabolic alkalosis

Answer 24

vomiting, NG suction
contraction alkalosis - dehydration
hypokalemia
correction for chronic resp acidosis

Question 25

signs of metabolic adidosis

Answer 25

kussmaul respiration
N/V
arrhythmia
neuro effects

Question 26

carpopedal spasm

Answer 26

metabolic alkalosis

-due to secondary hypocalcemia

Question 27

body never overcompensates

Answer 27

pH gives you primary

Question 28

acid base steps

Answer 28

1 - acidosis / alkalosis
2 - metabolic / respiratory
3 - compensated / uncompensated
4 - AG for metabolic
5 - if AG, calculate delta-delta (mixed)
6 - metabolic, look at pCO2 vs. bicarb - additional resp
7 - look at clinical picture