Acid Base Disorders CIS Flashcards
ventilation
gas gets to alveoli
minute ventilation
RR x TV
henderson hasselbach
pH = 6.1 + log(HCO3) / 0.03 x pCO2
primary acid base disorder
pathologic process
secondary acid base disorder
normal physiologic compensation to primary disorder
high anion gap metabolic acidosis
look at MUDPILES causes
normal anion gap metabolic acidosis
look at extra-renal loss (diarrhea)
-or renal loss (RTA)
causes of respiratory acidosis
hypoventilation
- drugs decreased resp drive
- decreased tidal volume anatomically
anion gap
Na - HCO3 - Cl
normal = 10
MUDPILES
methanol uremia (ESRD) diabetic ketoacidosis paraldehyde infection, iron, isoniazide lactic acidosis ethylene glycol, alcohol salicylates, starvation
uremic acidosis
severe renal function decrease
lactic acidosis
metformin HIV meds isoniazide liver failure seizures sepsis ischemia
diabetic ketoacidosis
more often DM I
-lipolysis - fatty acide to liver - ketones - acidosis
osmolar gap
2xNa + glucose/18 + BUN/2.8
normal less than 10
alcoholic ketoacidosis osmolar gap**
OG = ethanol /4.6
if not, look other alcohols
-ethylene glycol, methanol
tinnitus
ear ringing
-salicylate poisoning
causes of normal AG metabolic acidosis
diarrhea
decreased HCO3 reabsorption
increased anion intake
large NaCl (expansion acidosis)
contraction
alkalosis
expansion
acidosis
RTA type I
distal
- decreased H secretion
- alkaline urine**
- risk of stone formation
- hypokalemia
RTA type II
proximal
- defect bicarb reabsorption prox tub
- elevated urine bicarb
- low urine pH**
- hypokalemia
RTA type IV
distal hyperkalemic
- chronic renal failure
- insufficient aldosterone production or resistance
- hyperkalemia**
urinary anion gap
Na + K - Cl
negative - extrarenal loss (high NH4)
positive - renal loss (low NH4)
metabolic alkalosis
vomiting, NG suction
contraction alkalosis - dehydration
hypokalemia
correction for chronic resp acidosis
signs of metabolic adidosis
kussmaul respiration
N/V
arrhythmia
neuro effects
carpopedal spasm
metabolic alkalosis
-due to secondary hypocalcemia
body never overcompensates
pH gives you primary
acid base steps
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
