B4.038 - Interpreting Arterial Blood Gas Prework 2 Flashcards

1
Q

why do we care about acid base balance

A

automatic differential early sign of illness prevent end organ damage

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2
Q

what is a mixed acid base disorder

A

more than one disorder present, pH may be normal or abnormal, if abnormal trend toward the dominant disorder

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3
Q

what is an example of respiratory acidosis

A

Opioid overdose, decreased ventilation

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4
Q

what are acid base disorders accompanied by

A

expected compensation renal and respiratory

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5
Q

what will compensation do

A

just trend in right direction will NOT return pH to normal

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6
Q

what is metabolic acidosis

A

primary disturbance of blood HCO3 concentration where it is decreased

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7
Q

what are two types of metabolic acidosis

A

anion gap non anion gap

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8
Q

what is metabolic alkalosis

A

higher HCO3 concentration than normal usually due to retention

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9
Q

what is the normal compensatory mechanism for metabolic acid base imbalance

A

respiration changes in ventilation mediated by chemoreceptors in carotid body and lower brainstem

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10
Q

what are metabolic alkalosis causes

A

nasogastric suction, vomiting

diuretic therapy

Hyperaldosteronism - Addison’s disease

cushing syndrome

exogenous steroids

licorice overdose

alkali ingestion

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11
Q

what is anion gap acidosis

A

HCO3- used as buffer for acid

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12
Q

differentiate between anion gap metabolic acidosis and non anion gap metabolic acidosis

A

anion gap is when HCO3- used up as a buffer for acid

non anion gap is when its lost through urine or bowel

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13
Q

anion gap metabolic acidosis causes

A

methanol

uremia

DKA

paraldehyde

INH/Iron

Lactic acidosis - sepsis

ethylene glycol

salicylates/starvation

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14
Q

non gap metabolic acidosis

A

hyperailmentation

Diuretics

renal tubular acidosis

diarrhea

ureteroenteric fistula

pancreaticoduodenal fistula

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15
Q

why is it important to differentiate between anion gap metabolic acidosis and non anion gap metabolic aidosis

A

the treatments are very different

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16
Q

how do you treat non gap MA?

A

replace bicarb

17
Q

how do you treat anion gap MA

A

treat the underlyind disorder

you DONT give bicarb unless its severe

18
Q

what is winters formula

A

predicts the expected pCO2 for any given HCO3- level

expected pCO2 = (1.5 x [HCOD3-]) + 8 +/- 2

used in pts with metabolic acidosis to see if their respiratory compensation is enough

19
Q

normal compensation for repiratory disoders

A

metabolic in kidney

20
Q

respiratory acidosis is caused by

A

CO2 retention

decreased alveolar ventilation

21
Q

disorders causing respiratory acidosis

A

CNS depression/sedatives

neuromuscular disorder

thoracic cage limitations

Acute obstruction

chronic obstruction

ventilator malfunction

22
Q

disorders causing respiratory alkalosis

A

anxiety

CNS disorders

drugs- salicylates, analeptics

fever, sepsis (usually not, usually lactic acidosis)

pregnancy (FRC decreases – harder to maintain high TV)

liver insufficiency

hyperthyroidism