acid-base disturbances Flashcards
acidemia vs acidosis
you can have multiple -_____ contributing to the -_____
you can have multiple -osis contributing to the -emia
alkalemia vs alkalosis
define pH
how much [H+] present
lower pH = _____ H+ ions
MORE
blood is _____ in a deceased person
acidotic
equation relating pH, HCO3-, PCO2
pH = HCO3- / PCO2
in a metabolic condition, when pH increases = _____ HCO3- or _____ PCO2
(what is this condition called)
increases HCO3-
metabolic alkalosis
in a metabolic condition, when pH decreases = _____ HCO3- or _____ PCO2
(what is this condition called)
decreases HCO3-
metabolic acidosis
in a respiratory condition, when pH decreases = _____ HCO3- or _____ PCO2
(what is this condition called)
increases PCO2
respiratory acidosis
in a respiratory condition, when pH increases = _____ HCO3- or _____ PCO2
(what is this condition called)
decreases PCO2
respiratory alkalosis
respiratory acidosis mechanism
breathing slowly
->
increases PCO2
->
decreases pH
respiratory alkalosis mechanism
breathing quickly / hyperventilation
->
decreases PCO2 (lose it to air)
->
increases pH
does changing HCO3- or PCO2 drive pH change in metabolic conditions
HCO3-
does changing HCO3- or PCO2 drive pH change in respiratory conditions
PCO2
in metabolic acidosis, which organ compensates & how
metabolic acidosis: decrease pH = decrease HCO3-
lungs compensate: by decreasing PCO2 to increase pH
in metabolic alkalosis, which organ compensates & how
metabolic alkalosis: increase pH = increase HCO3-
lungs compensate: by increasing PCO2 to decrease pH
in respiratory acidosis, which organ compensates & how
respiratory acidosis: decrease pH = increase PCO2
kidneys compensate: by increasing HCO3- to increase pH
anion gap equation
anion gap = (Na+) - (Cl- + HCO3-)
normal anion gap value
12 +/- 2
what does it mean if anion gap is normal, & what condition do you not have
there has been no new anions introduced to blood (ex. ketones in DKA)
AGMA (anion gap metabolic acidosis)
how long does it take kidneys to compensate in response to respiratory condition
48-72 hrs
how long does it take lungs to compensate in response to metabolic condition
immediately
normal pH
7.4
normal HCO3- reported as CO2
24
normal PCO2
40
what does abnormally normal mean
if a lab value is normal but based on other lab values it shouldn’t be
if pH & PCO2 are BOTH increasing / decreasing (arrows in same direction), then what condition type is present
primary metabolic
if pH & PCO2 arrows are in opp. direction, then what condition type is present
primary respiratory
Barnes’ steps for acid-base disorders
1) alkemia vs acidemia (pH increase/decrease from 7.4)
2) pH & PCO2 arrow direction (metabolic vs respiratory)
3) calculate anion gap (AGMA vs NAGMA)
4) did expected compensation occur? (if not- an additional condition is present)
if pH is less than 7.4, what condition type is present
acidemic
if pH is more than 7.4, what condition type is present
alkalemic
2 characteristics of AGMA (anion gap metabolic acidosis)
HCO3- decreases (bc you’re using it)
widened anion gap
we don’t use the term _____ when describing conditions, what does this mean instead
uncompensated
that an additional condition is present as well
