Acid- Base Worksheet -Wolff

Question 1

Equation for finding pH for carbonic acid (H2CO3) ——> HCO-3 + H+
OR
——> H2O + CO2

Answer 1

pH = 6.1 + log ([HCO-3] / H2CO3)
pH = 6.1 + log (24mEg/L) / (0.03 x 40mmHg)
*H2CO3 = 0.03 x Pco2
pH = 7.4

Question 2

How to convert equation to solve for x:

Log (x) = 8

Answer 2

10^8 = x

Question 3

For every 10mmHg that Pco2 increases what happens to [HCO-3] in ACUTE

Answer 3

Increases by 1mEg/L

Question 4

For every 10mmHg that Pco2 increases what happens to [HCO-3] in CHRONIC

Answer 4

Increases by 3.5mEg/L

= respiratory acidosis

Question 5

For every 10mmHg that Pco2 decreases what happens to [HCO-3] in ACUTE

Answer 5

Decreases by 2mEq/L

Question 6

For every 10mmHg that Pco2 decreases what happens to [HCO-3] in CHRONIC

Answer 6

Decreases by 5mEq/L

= respiratory alkalosis

Question 7

Serum Anion Gap should be what and calculated how

Answer 7

8-16
[NA] - [Cl] + [HCO-3]
*if higher value : other solutes in serum like lactic acid, alcohol, ketoacidosis

Question 8

Urine Anion Gap is calculated how and what should it be

Answer 8

20-90 (no NH+4 measured)
[Na] + [K] - [Cl]
* if negative value = metabolic acidosis (lots of NH+4 is excreted)
*renal tubular acidosis can still show + value

Question 9

SERUM Osmolal Gaps

How to calculate serum osmolarity gap and what should it be

Answer 9

0

Serum Osm - (2[Na] + [K]) + glucose/18 + BUN/2.8

Question 10

Of serum osmolarity gap is greater then 10

Answer 10

Other solutes present in the plasma like alcohol, lactic acid, ketoacidosis

Question 11

URINE Osmolal Gaps

How to calculate urine osmolarity and what should it be

Answer 11

10-100

Urine osm - (2[Na] + [K]) + glucose/18 + BUN/2.8

Question 12

Urine osmolarity gap lower then 75

Answer 12

Renal tubular acidosis

Question 13

Urine osmolarity gap around 200-300

Answer 13

Chronic severe metabolic acidosis

Question 14

Delta Gap =

Answer 14

Anion Gap calculated- normal anion gap

Anion gap calculated - 12

Question 15

Delta [HCO-3] is calculated how and what does it mean if measured HCO-3 is equal, less, greater, then delta HCO-3

Answer 15

Delta HCO-3 = [HCO-3] - delta Gap

1. measured [HCO-3] is = delta HCO-3 : simple a-b disorder
2. measured [HCO-3] is > delta HCO-3 : metabolic acidosis + HAGMA
3. measured [HCO-3] is < delta HCO-3 : non-gap metabolic acidosis + HAGMA

Question 16

HAGMA

NAGMA

Answer 16

High anion gap metabolic acidosis

Normal anion gap metabolic acidosis

Question 17

Low HCO-3
High Pco2
PH low

Answer 17

Mixed metabolic acidosis + respiratory acidosis

Question 18

Low HCO-3
Low Pco2
PH low

Answer 18

Predominant metabolic acidosis

Question 19

High HCO-3
High Pco2
Ph low

Answer 19

Predominantly respiratory acidosis

Question 20

Low HCO-3
High Pco2
PH high

Answer 20

Not possible

Question 21

High HCO-3
High Pco2
PH high

Answer 21

Metabolic alkalosis

Question 22

Low HCO-3
Low Pco2
PH high

Answer 22

Respiratory alkalosis

Question 23

High HCO-3
Low Pco2
PH high

Answer 23

Mixed respirator alkalosis + metabolic alkalosis