Acid base final exam

Question 1

acidodic pH

Answer 1

less than 7.35

Question 2

alkalotic pH

Answer 2

7.45

Question 3

AE of acidemia

Answer 3

-decreased CO output
-insulin resistance
-hyperkalemia
-hyperventilation

Question 4

AE of alkalemia

Answer 4

-decreased electrolytes
-decrease central blood flow

Question 5

where is bicarb primarily reabsorbed

Answer 5

proximal tubule

Question 6

bicarb reabsorption moa

Answer 6

-filtered bicarb combines with secreted Hydrogen
-water and co2 created
-water and co2 reabsorbed
-they disassociate and bicarb is reabsorbed back into the body

Question 7

bicarb generation/H+ excretion moa

Answer 7

-ammoniagenesis where hydrogen is excreted and forms NH4, then bicarb is generated

Question 8

metabolic acidosis changes

Answer 8

decreased bicarb
lungs faster/decreased CO2

Question 9

metabolic alkalosis changes

Answer 9

increased bicarb
lungs slower/increased CO2

Question 10

respiratory acidosis changes

Answer 10

increased CO2
kidneys increase bicarb

Question 11

respiratory alkalosis changes

Answer 11

decreased CO2
kidneys decrease bicarb

Question 12

what are the two kinds of metabolic acidosis

Answer 12

anion gap
non anion gap

Question 13

how to calculate anion gap

Answer 13

Na - (Cl + bicarb)

Question 14

normal anion gap

Answer 14

3-11

Question 15

high anion gap

Answer 15

above 11

Question 16

what is non-anion gap acidosis

Answer 16

loss of plasm bicarb replaced by Cl

Question 17

causes of non-anion gap

Answer 17

GI bicarb loss
Renal bicarb loss
Acid & chloride administration
reduced renal hydrogen excretion

Question 18

what is anion gap acidosis

Answer 18

loss of plasma bicarb replaced w/ ion other than Cl

Question 19

causes of anion gap

Answer 19

MUDPILES

Question 20

how to confirm mixed disorders

Answer 20

calculate delta gap then add it to patients bicarb

Question 21

what is MUDPILES

Answer 21

Methanol intox
Uremia
DKA
Poisoning/propylene glycol
Intoxicated/Infection
Lactic Acidosis
Ethylene Glycol
Salicylate/Sepsis

Question 22

How to treat anion gap acidosis

Answer 22

address underlying cause
consider bicarb therapy

Question 23

when to do acute bicarb therapy

Answer 23

pH less than 7.1, hyperkalemia

Question 24

how to dose acute bicarb

Answer 24

0.5 L/kg x IBW x (12 - actual bicarb) then give 1/2-1/3 of this

Question 25

causes of metabolic alkalosis

Answer 25

loss of acid from GI tract/urine
giving bicarb precursor
losing Cl rich of bicarb poor fluid

Question 26

what are the two types of metabolic alkalosis

Answer 26

saline responsive or resistant

Question 27

what causes saline responsive metabolic alkalosis

Answer 27

diuretics
vomiting and NG suction
exogenous bicarb admin

Question 28

how to treat saline responsive alkalosis

Answer 28

fluids and potassium supplements
carbonic anhydrase inhibitors

Question 29

saline resistant causes

Answer 29

increased mineralocorticoid activity
hypokalemia
renal tubular chloride wasting

Question 30

saline resistant treatment

Answer 30

correct hypokalemia w/ potassium sparing diuretic or supplementation
decrease or change steroid
spironolactone
correct hyperaldosteronism