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CLIN MED3: GU/Renal > Acid-Base Disorders - fiore > Flashcards

Acid-Base Disorders - fiore Flashcards

1
Q

What maintains the bicarbonate buffer system

A

Lungs and Kidneys
Co2= acid
HCO3 = Base

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2
Q

What are the different acid based disorders

A

Respiratory acidosis
respiratory alkalosis
metabolic acidosis
metabolic alkalosis

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3
Q

how are acid based disorders characterized

A

by the PRIMARY abnormality
(possible to have mixed disorder)

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4
Q

What is respiratory acidosis

A

pH < 7.4secondary to respiratory disturbance
acid retention (CO2)

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5
Q

what is the hallmark of respiratory acidosis

A

increased PaCO2

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6
Q

what is respiratory alkalosis

A

pH > 7.4 secondary to respiratory distubance
excess acid loss (CO2)

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7
Q

what is hallmarked by decreased PaCO2

A

Respiraotry Alkalosis

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8
Q

what is metablic acidosis

A

pH < 7.4 secondary to ‘metabolic’ disturbance
decreased acid excretion - accumulation
increased acid load (ketones, lactate)
redcued level of base (HCO3)

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9
Q

how are metabolic acidosis classified

A

non-anion gap metabolic acidosis
anion gap metabolic acidosis

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10
Q

What is the normal AG

A

8-15

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11
Q

when is Anion Gap (AG) considered Wide

A

> 15
problem related to other acids

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12
Q

what is assoicated with wide AG

A

Kenoacidosis
lactic acidosis
other toxins
renal fialure (late stage)

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13
Q

What are causes of Non-Anion Gap Metabolic Acidosis

A

HARDUPS
* Hyperalimentation (IV nutrition)
* acetazolamide, Addison’s
* Renal Tubular acidosis
* diarrhea, dehydration, diuretics
* Ureteral diversion
* Post - hypocapnia, pancreatic fistula/drainage
* Spironolactone, saline resuscitation

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14
Q

What is metabolic Alkalosis

A

pH > 7.4 secondary to metabolic disturbance
excess acid excretion
increased level of base (HCO3)

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15
Q

what is hallmarked by increased serum levels of HCO3

A

metabolic alkalosis

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16
Q

what are causes of Metabolic alkalosis

A

Barf (vomiting)
excessive corticosteroid action
alkali admin
rapid correction of hypercapnia, renin secreting tumor, renal artery stenosis
diuretics, diarrhea/lax abuse
suction (NG)

17
Q

pt is/has been vomiting

A

metabolic alkalosis

18
Q

pt is a diabetic

A

metabolic acidosis

19
Q

pt is smoker/has COPD

A

respiratory acidosis

20
Q

pt with a hx of liver disease

A

respiratory alkalosis

21
Q

pt with recent heavy ETOH use

A

metabolic acidosis

22
Q

pt has/had diarrhea

A

metabolic acidosis

23
Q

pt is tachypneic

A

respiratory alkalosis

24
Q

pt is hypotensive

A

metabolic acidosis

25
Q

pt is post-respiratory/cardiac arrest

A

respiratory acidosis

26
Q

What are the symptoms of metabolic acidosis

A

hyperventilation(Compensatory)
hypotension (reduced CO, vasodilation)
ventricular arrhythmias (electrolytes)
neurologic symptoms

27
Q

what are the symptoms of metabolic alkalosis

A

neurologic symtpoms (paresthesias, AMS)
symptoms of hypvolemia

28
Q

what are symptoms of respiratory acidosis

A

metabolic encephalopathy (CNS depres)
HA/Drowsiness (CNS depres)
coma
decreased CO
pulonary HTN

29
Q

what are the symptoms of respiratory alkalosis

A

hypervent
tetany-like syndrome
paresthesias
giddiness
lightheadedness

30
Q

what is the gold standard for evaluation of:
* acid-based balance
* oxygenation
* ventilation

A

ABG

31
Q

what are the indications for ABG

A

critically ill
respiratory conditions
metabolic disorders

32
Q

what does ABG tell us

A
  • pH
  • Partial pressure of Oxygen (PaO2, PO2)
  • partial pressure of carbon dioxide (PaCO2, PCO2)
  • bicarbonate (HCO3) concentration
  • degree of excess or deficit of base in blood
  • oxygen saturation (SaO2)
33
Q

What is normal PaO2/PO2 levels

A

75-100 mmHg

34
Q

What is normal PaCO2/PCO2

A

35-45 mmHg

35
Q

what is normal HCO3

A

22-26 meg/L

36
Q

what is the calculation of AG

A

Na+ - (Cl- + HCO3)
BMP/CMP

CLIN MED3: GU/Renal (11 decks)

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