Approach to Clinical Acid-Base Disorders

Question 1

Hyperglycemia findings

Answer 1

Ostomotic diuresis - high tonicity draws H2O from IC compartment which is lost in urine

Also volume dpeelted so polydipsia

Blurry vision from high blood gluocse levels

Altered sensorium at very high glucose concentrations

Question 2

AGAP and albumin

Answer 2

Decrease 2.5 mmol/L for every 1 g/dL decrease in albumin

Question 3

Isopropyl alcohol and keotacidosis

Answer 3

Causes acute resp acidosis

Test for acetone and acetoacetate

Question 4

Ethylene glycol toxicity

Propylene glycol toxicity

5-oxoproline toxocity

Answer 4

Renal failure, increased AGAP and OGAP…oxalate crystals

Used in phenytoin, lorazepam, topical silver sulfadiazene

Acetominophen use results in low glutathione level

Question 5

Tx of diabetic ketoacidosis

Answer 5

After tx, the AGAP will become normalized

Question 6

Lactic acidosis

Answer 6

Will increase the AGAP

Question 7

Moderation and A-B disorders

Answer 7

Lots of acid is bad but a little acid may help

Giving HCO3 may hurt the cell