Acid-Base therapeutics

Question 1

Acidosis

Answer 1

metabolic (decrease in HCO3 =45mmHg

Question 2

Alkalosis

Answer 2

metabolic (increase in HCO3>=28 mEq/L

respiratory (decrease in pCO2

Question 3

Lung compensation

Answer 3

regulate acute changes (occurs within seconds), regulates PCO2 through respiration rate and depth changes

Question 4

Renal compensation

Answer 4

regulation chronic changes (takes hours to days to compensate), regulates HCO3 and H through excretion/reabsorption/buffer

Question 5

Primary metabolic disorder with respiratory compensation

Answer 5

Metabolic acidosis -> compensate with respiratory alkalosis

Metabolic alkalosis -> compensate with respiratory acidosis

Question 6

Primary respiratory disorder with metabolic compensation

Answer 6

Respiratory acidosis -> compensate with metabolic alkalosis

Respiratory alkalosis -> compensate with metabolic acidosis

Question 7

Clinical manifestation of acidosis

Answer 7

Hyperventilation
CNS depression
Hypotension
Hyperkalemia
Arrhythmias
↓ contractility

Question 8

Clinical manifestation of alkalosis

Answer 8

Nerve excitation
Arrhythmias
Respiratory depression
Hypoventilation
Hypokalemia

Question 9

pH

Answer 9

acidemia

Question 10

pH> 7.40

Answer 10

alkalemia

Question 11

Anion gap equation

Answer 11

AG=Na-Cl-HCO3

Question 12

Correction for albumin

Answer 12

for every 1g/dL decrease in albumin, add 2.5 to AG

Question 13

Winter’s formula (for metabolic acidosis)

Answer 13

Expected pCO2= 1.5 (HCO3)+ 8 (plus or minus 2)

Question 14

Expected increase in pCO2 with metabolic alkalosis

Answer 14

Expected increase in pCO2= 0.75 (patient HCO3- normal HCO3)

Question 15

If AGMA, check the corrected HCO3

Answer 15

Corrected HCO3= patient’s HCO3+(patient’s AG-normal AG)