DSA Introduction to Acid Base - Karius

Question 1

another way of saying arterial bicarbonate

Answer 1

plasma CO2

Question 2

normal PaO2 normal PaCO2 normal HCO3 normal arterial pH

Answer 2

age dependant (80-100mHg) 40mmHg 24mEg/L 7.40

Question 3

CO2 and pH relationship

Answer 3

indirect

Question 4

HCO-3 and pH relationship

Answer 4

direct

Question 5

respiratory a-b disturbance is what

Answer 5

when the change in pH is due to CO2 (NOT HCO-3)

Question 6

metabolic a-b disturbance is what

Answer 6

when the change in pH is due to HCO-3 (NOT CO2)

Question 7

when finding acid base disturbances what is the: Step 1 Step 2 Step 3

Answer 7

step 1 : look at pH (is it normal, acid, basic) step 2 : is the paCO2 and HCO-3 normal low or elevated and which one is causing a change in pH step 3 : if respiratory (is it acute or chronic) if metabolic (gap anion, osmol gap, respiratory compensation, chloride disturbance)

Question 8

respiratory acidosis acute

Answer 8

increase in 10mmHg PaCO2 = 1mEg/L increase in HCO-3 HCO3 = 24 + 0.1(PaCO2 -40)

Question 9

respiratory acidosis chronic

Answer 9

increase in 10mmHg PaCO2 = 4mEg/L increase in HCO-3 HCO3 = 24 + 0.4(PaCO2 -40)

Question 10

respiratory alkalosis acute

Answer 10

decrease in 10mmHg PaCO2 = 2mEg/L decrease in HCO-3 HCO3 = 24 - 0.2(PaCO2 -40)

Question 11

respiratory alkalosis chronic

Answer 11

decrease in 10mmHg PaCO2 = 5mEg/L decrease in HCO-3 HCO3 = 24 - 0.5(PaCO2 -40)

Question 12

respiratory a-b that is in between chronic and acute

Answer 12

both are occurring disease like pneumonia and COPD

Question 13

metabolic acidosis with adequate respiratory compensation is calculated how

Answer 13

PaCO2 = (1.5[HCO-3] +8) +/-2

Question 14

metabolic alkalosis with adequate respiratory compensation is calculated how

Answer 14

change in PaCO2 = 0.5 to 1.0 (change in HCO3) (40-PaCO2) = x (24-HCO-3) x = 0.5 to 1.0

Question 15

metabolic ACIDOSIS with anion gap is calculated how (serum)

Answer 15

anion gap = 8-16 (average 12) *NORMAL anion gap = [Na] -[Cl] + [HCO-3}

Question 16

when do you calculate anion gap

Answer 16

if I find metabolic acidosis

Question 17

when to check for chloride responsive a-b disturbance

Answer 17

if I find metabolic alkalosis

Question 18

how to calculate chloride responsive

Answer 18

[Cl] < 20 mEq/L in URINE if [Cl] is > 20mEq/L = chloride resistant

Question 19

what can cause chloride resistance

Answer 19

hypokalemia hyeraldosteronism K+ -loosing diuretics

Question 20

during metabolic a-b disturbance what happens in the body to respond to this

Answer 20

the change in H+ —-> stimulate the peripheral chemoreceptors to produce respiratory compensation

Question 21

what can cause a metabolic disturbance

Answer 21

1. KIDNEY : decide how much to excrete HCO-3 + H+ in urine 2. ingesting bicarb like tums(metabolic alkalosis) 3. anaerobic exercising, lactic acid (metabolic acidosis) 4. GI secretes HCO-3 and H+ = diarrhea and vomiting leads to huge loss of HCO-3 (metabolic acidosis) 5. ketoacidosis (metabolic acidosis)

Question 22

arterial pH is changes by CO2 and HCO-3 (and H+) shown in what reaction

Answer 22

CO2 +H2O —-> H2CO3 —-> HCO-3 + H+

Question 23

what can cause respiratory a-b disturbance

Answer 23

1. increased H+ or increased carbonic acid (H2CO3) = INCREASED PaCO2 (respiratory acidosis) 2. change in CO2 gas exchange at alveoli : pneumonia, interstitial fibrosis, pulmonary edema, V/Q inequalities (respiratory acidosis) 3. hyperventilating : decrease PaCO2 (respiratory alkalosis)

Question 24

urine anion gap is calculated how

Answer 24

this equation

Question 25

osmolality gap is calculated how

Answer 25

this equation