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CRRAB II Week 3 > Acid Base Phys- Kleinshcmidt > Flashcards

Acid Base Phys- Kleinshcmidt Flashcards

1
Q

What is normal serum [Na+]?

A

140

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2
Q

What is normal serum [K+]?

A

4

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3
Q

What is normal serum [Cl-]?

A

108

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4
Q

What is normal BUN?

A

10

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5
Q

How do you calculate anion gap? What is the normal value?

A

[Na+]- (Cl + HCO3)

Normal = 12

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6
Q

How do you calculate the osmol gap?

A

Measured osmol- calculated

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7
Q

How do you calculate osms?

A

2[Na] + (glucose/18) + (BUN/2.8)

**usually around 285 ish

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8
Q

pH 40 mmHg?

A

Respiratory Acidosis

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9
Q

pH

A

Metabolic Acidosis with respiratory compensation

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10
Q

pH > 7.45 and pCO2

A

Respiratory alkalosis

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11
Q

pH > 7.45 and pCO2 > 40 mmHg

A

Metabolic alkalosis

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12
Q

What is the primary disturbance in respiratory acidosis?

A

Increased arterial CO2 due to lack of ventilation:

airway obstruction
Acute lung disease
Chronic lung disease
Opioids, sedatives

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13
Q

How do you determine the Delta Gap?

A

Calculate the excess anion gap (Calculated anion gap - 12)

Add that to the measured bicarbonate.

Should equal a normal bicarb level of ~24

If it is low, it means there is also a non anion gap acidosis. If it is high there is an underlying metabolic alkalosis.

Example: 24 - 12 = 12 (so the bicarbonate should be 12 points lower than it normally should be because a change of gap of 1 will drop the bicarbonate by an equal amount!

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14
Q

What is a normal serum bicarbonate level?

A

24

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15
Q

What is the compensation of a high anion gap acidosis?

A

Blow off CO2

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16
Q

How can you determine the pCO2 in a high anion gap acidosis?

A

Last 2 digits of pH!

Ex. pH is 7.20 then pCO2 is 20

17
Q

What are the DDX’s of high anion gap metabolic acidosis?

A 
Methanol
Uremia
DKA/AKA
Paraldahyde
Iron or INH (Isoniazid for TB tx)
Lactic acid
Ethylene glycol/ethanol
Salicylates

MUDPILES

18
Q

When would you see a normal anion gap acidosis?

A

Loss of bicarbonate from kidney of GI

19
Q

What do you see an equal rise in for the loss of bicarbonate?

A

Chloride

20
Q

What is the primary disturbance in metabolic alkalosis?

How do you compensate?

A

Increased bicarbonate

Compensate by hypoventilating

21
Q

What is acute compensation in respiratory acidosis?

A

Bicarbonate rises 1 mEq for each rise of 10 of pCO2

22
Q

What is chronic compensation in respiratory acidosis?

A

Bicarbonate rises 3 mEq for each rise of 10 pCO2

23
Q

What is acute compensation for respiratory alkalosis?

A

Bicarbonate falls 2 mEq for each drop of 10 of pCO2

24
Q

What is chronic compensation for respiratory alkalosis?

A

Bicarbonate falls by 4 mEq for each drop of 10 of pCO2

CRRAB II Week 3 (7 decks)

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