Ch 21: Electrolyte & Acid-Base Disorders

Question 1

Chronic respiratory failure which leads to renal excretion of acid as NH4Cl results in…

Answer 1

…hypochloremia.

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Question 2

When chronic respiratory acidosis is corrected suddenly, _______________ _________ _________ ensues until the kidneys excrete the excess bicarbonate over 2 - 3 days.

Answer 2

posthypercapnic metabolic alkalosis

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Question 3

What signs may be seen in acute onset respiratory acidosis?

Answer 3

somnolence, confusion, asterixis, myoclonus

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Question 4

What are the effects on intracranial hemodynamics in severe hypercapnia?

Answer 4

increased cerebral blood flow
increased cerebrospinal fluid pressure
increased intracranial pressure 
papilledema
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Question 5

What is pseudotumor cerebri?

Answer 5

a condition in which the pressure around your brain increases, causing headaches and vision problems. The name means “false brain tumor”.
(p. 910)

Question 6

Respiratory etiologies of respiratory acidosis usually have a wide…

Answer 6

…A-a gradient.

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Question 7

A relatively normal A-a gradient in respiratory acidosis suggests a…

Answer 7

…nonpulmonary (e. g. central) etiology.

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Question 8

What drug can be given as a trial in a case with no other obvious cause for hypoventilation?

Answer 8

naloxone (Narcan)

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Question 9

Symptoms of acute respiratory alkalosis are related to…

Answer 9

…decreased cerebral blood flow.

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Question 10

What causes respiratory alkalosis in pregnancy?

Answer 10

Progesterone stimulates the respiratory center, producing an average PCO2 of 30 mm Hg.
(p. 910)

Question 11

Although serum HCO3- is frequently less than 15 mEq/L in metabolic acidosis, such a low level in respiratory alkalosis is unusual and may represent…

Answer 11

…a concomitant primary metabolic acidosis.

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Question 12

Tetany can occur as a result of respiratory alkalosis because…

Answer 12

…severe alkalosis increases calcium binding to albumin, resulting in a low ionized Ca++.
(p. 911)

Question 13

What signs/symptoms may be seen in acute onset respiratory alkalosis?

Answer 13

light-headedness, anxiety, perioral numbness, and paresthesias
(p. 911)

Question 14

Serum bicarbonate is _________ in chronic respiratory alkalosis.

Answer 14

decreased

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Question 15

Hyperventilation is usually ____-_______ since muscle weakness caused by the respiratory alkalemia will ________ ___________.

Answer 15

self-limited; suppress ventilation

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Question 16

Why doesn’t the traditional treatment of breathing into a paper bag during hyperventilation work?

Answer 16

Because it does not correct PCO2 and may decrease PO2.

p. 911