Ch 66: Acidosis and Alkalosis

Question 1

The degree of respiratory compensation expected in a simple form of metabolic acidosis can be predicted from what equation?

Answer 1

PaCO2 = (1.5 x [HCO3-]) + 8 +/- 2

p. 316

Question 2

Thus, a patient with metabolic acidosis and [HCO3-] of 12 mmol/L would be expected to have a PaCO2 between…

Answer 2

…24 and 28 mmHg.

p. 316

Question 3

If the PaCO2 were < 24, this would define a…

Answer 3

…mixed disturbance (metabolic acidosis and respiratory alkalosis specifically).

(p. 316)

Question 4

If the PaCO2 were > 28, this would define a…

Answer 4

…mixed disturbance (metabolic alkalosis and respiratory acidosis specifically).

(p. 316)

Question 5

Changes in PaCO2 and HCO3- in opposite directions (i.e. CO2 is high and bicarb is low, or vice versa), indicate a…

Answer 5

…mixed disturbance.

p. 316

Question 6

Patients with underlying pulmonary disease (e. g. COPD) may not respond to metabolic acidosis with an appropriate ventilatory response because…

This can result in imposition of respiratory acidosis on metabolic acidosis that can lead to…

Answer 6

…of insufficient respiratory reserve.

…severe acidemia
p. 316

Question 7

Acute respiratory acidosis is compensated for by the HCO3- increasing by __ mmol/L for every __ mmHg increase in PaCO2.

Answer 7

1
10
(p. 322)

Question 8

Chronic respiratory acidosis is compensated at rate of __ mmol/L increase in HCO3- for every __ mmHg increase in PaCO2

Answer 8

4
10
(p. 322)

Question 9

In general, the serum HCO3- does not increase above…

Answer 9

…38 mmol/L.

p. 322

Question 10

The PaCO2 in chronic CO2 retainers should be lowered _________.

Answer 10

gradually

p. 323

Question 11

Respiratory alkalosis reduces free Ca++ by increasing…

Answer 11

…the protein-bound fraction.

p. 323

Question 12

What is the most common cause of drug-induced respiratory alkalosis?

Answer 12

salicylates

p. 324

Question 13

The diagnosis of hyperventilation syndrome is made by…

Answer 13

…exclusion

p. 325