Acid Base Questions

Question 1

What is the anion gap and what is it used for?

Answer 1

NA - (CL + HCO3)

Helps define underlying cause of metabolic acidosis.

Question 2

What is metabolic acidosis?
What is it due to?
What is the compensatory response?
How to treat met acidosis?

Answer 2

Low pH and low bicarbonate due to increased acid production in the body(diabetic ketoacidosis, lactic acidosis) or to
loss of bicarb due to severe D. Or a diminished ability of kidney to excrete acid.
Increase in ventilation to decrease the PaCO2 to normalize pH as in Kussmaul breathing in DKA
In addition to treating the underlying disorder give IV sodium bicarb

Question 3

What are causes of increased anion gap metabolic acidosis?

Answer 3

Lactic acidosis: due to reduced systemic perfusion and tissue hypoxia;
Diabetic ketoacidosis;
Renal Failure;
Toxic agent ingestion: ethylene glycol, overdose of asa

Question 4

What is the cause of normal anion gap metabolic acidosis?

Answer 4

Severe D causing marked bicarb loss.

Question 5

What type electrolyte change occurs in any alkalosis?

Answer 5

Hypokalemia.

In alkalosis the H ions come out of the cells and are released into the serum, so K moves from the serum into the cells.