Acidosis Flashcards
what organs are affected by acid-base disorders?
heart, bones, skeletal muscle, kidneys
What is the response of the bones when acid level is high in the body?
They break down releasing alkali to neutralize the acid. Calcium is released at the same time (kidney stones, osteoporosis)
What happens in the heart in the presence of excess acid?
Increased risk of arrhythmia and impaired contractility
What happens in the skeletal muscles as a result of excess acid?
Protein catabolism
Calcium competes with __________ to bind with Albumin
Protons (H+)
If you treat your acidotic patient with bicarb they will have a decrease in H+, what would you expect to happen to the patient’s calcium?
It would bind to albumen and there would be less free calcium
If you have a decrease in H+, what would you expect to happen to Hemoglobin’s affinity for O2?
It would increase hgb’s affinity for oxygen (tissue would not want to release O2)
if you have a decrease in H+, what would you expect to happen to respiration?
Low H+ inhibits respiration (slow respiration increases pCO2)
what’s the equation to determine pH from H+ count?
pH=-log[H+]
What is normal pH?
7.35-7.45
What are the 2 factors that alter pH?
CO2 and HCO3-
Where is bicarb created?
kidneys
So the professor seemed to want us to know the Henderson-Hasselbach equation….but I think we just need to understand the idea that pH relies on bicarb and co2…..Just in case, what’s the HENDERSON-HASSELBACH EQUATION?
pH=6.1+log[(HCO3-)/0.03 * pCO2]
How long does it take your body to produce a respiratory compensation to an acid-base situation?
seconds
How long does it take your body to produce a metabolic compensation to an acid-base situation?
3-5 days
If your patient shows signs of a metabolic compensation to a respiratory alkalosis, you can assume the patient’s respiratory alkalosis is _____________, and has been going on for __________days
chronic, >3-5 days
What lab test would you order to measure pH?
1) Arterial blood gas (direct measure of pH and pCO2) AND
2) Plasma electrolytes (direct measure of HCO3-)
you can calculate HCO3- from the blood gases, and then test #2 confirms your calculation to let you know the test is valid.
You’ve discovered an abnormal pH, what is the best thing you should do?
Identify and treat underlying cause (treating pH does not solve your problems)
What are the 3 things that could cause metabolic acidosis?
1) too much acid (ASA and other meds)
2) not enough base/bicarb–not making enough in kidneys
3) not enough base/bicarb–losing too much in diarrhea
THROWBACK: how do you calculate the target anion gap for your patient?
Normal gap is Age/10 + 10
How do you calculate the actual anion gap for your patient?
All cations - anions
If you have metabolic acidosis and no anion gap, what are the 2 potential causes?
1) renal tubular failure (can’t make enough bicarb)
2) diarrhea
what test should we order if we want to know how much acid is being excreted?
chloride somehow translates to ammonia??
The new “MUDPILES”–>
LAME SUDS. Only addition is “alcoholic ketoacidosis” REVIEW: lactic acidosis, alcoholic ketoacidosis, methanol, ethylene glycol, salicylates, uremia, DKA, sepsis
