Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Year2 Renal > Exam 3- Pales- acid base > Flashcards

Exam 3- Pales- acid base Flashcards

1
Q

what is hyperkapnia or hypokapnia

A

increased or decreased CO2 in blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is minute ventilation

A

rate by which air reaches alveoli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the quickest compensation mechanism of the body(minutes)

A

buffering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how long does metabolic compensation take in kidneys

A

2-3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What can cause respiratory acidosis

A

decreased RR or decreased Tidal Volume

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are the causes of decreased RR

A

decreased drive: drugs, coma stroke

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are causes of decreased tidal volume

A 
neuro-muscular disorders
severe kyphoscholiosis
ariway obstruction
COPD
obstructive sleep apnea/obesity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the types of metabolic acidosis

A

normal anion gap and high anion gap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what does anion gap actually mean

A

unmeasured anions in plasma: albumin, phosphate, sulfate, organic anions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are causes of high anion gap metabolic acidosis

A

methanol, uremia, diabetic ketoacidosis, paraldehyde, infection, iron, isoniazide, lactic acidosis, ethylene glycol, alcohol, salicylates, starvation ketoacidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is uremic acidosis

A

severe renal fucntion

Creatinine is less than 25

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what causes uremic acidosis

A

decreased excretion of acids, J and decreased reabsorption of HCO3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are causes of lactic acidosis

A

anaerobic metabolis: hypozemia, circulatory failure, peripheral vessel blockage, anemia
medications: metformin, some HIV meds and isoniazide
liver failure, thiamine deficiency, hypophosphatemia
sepsis and seizures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do you Dx lactic acidosis

A

measuring venous or arterial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What causes diabetic ketoacidosis

A

insulin deficiency increases lypolysis which increase FFA to liver and increase ketone production leading to acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

how does alcohol lead to ketoacidosis

A

altered hormonal and enzymatic activities leading to ketone production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is difference of diabetic ketoacidosis with alcoholic?

A

no hyperglycemia in alcoholic ketoacidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is a normal osmol gap

A

<10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is calculated osmolality

A

2 Na+ glucose/18 +BUN/2.8

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how do you know if acidosis caused by ethanol

A

ethanol level/4.6 should be equal to the osmol gap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are signs of ethylene glycol poisoning

A

metabolites hgihly toxic
increased osmol gap
Ca oxalate crystals in urine
ARF common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are signs of methanol poisoning

A

found in wood alcohol and windshield fluid, causes blindess and ARF
increased osmol gap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are symptoms of salicylates poisoning

A

hemorrhage, fever, nausea, vomiting, diaphoresis, tinnitus, pulmonary edema

24
Q

what are causes of normal anion gap metabolic acidosis

A

diarrhea, ileal drainage with stoma/bypasses
decrease reabsorption of HCO3 by renal tubules
Increase anion intakes
large amount to NaCl

25
how does diarrhea lead to metabolic acidosis
loss of HCO3 | unless chloride wasting diarrhea with villous adenoma
26
what can cause a decrease in reabsorption of HCO3 by renal tubules
RTA | CA inhibitors
27
what can lead to a large amount of NaCl in normal anion gap metabolic acidosis
"expansion acidosis" dilution of bicarb | decreased bicarb reabsorption from volume expansion
28
describe RTA type I
distal. decreased H excretion in collecting ducts increased Ca excretion and decreased citric acid concentration leading to kidney stone formation increased potassium loss
29
describe RTA II
defect in HCO3 reabsorption in proximal tubules increased Ca in urine, but normal citric acid concentration distal tubules ok so try to compensate urine pH( will not see a big difference from normal) hypokalemia
30
describe RTA IV
distal hyperkalemic in patients with moderate chronic renal failure insufficient aldosterone production or aldosterone tubular resistance insufficient K excretion leads to hyperkalemia
31
What is the pH in all types RTA
type I >5.5 | type II <5.5
32
what are serum K levels in types of RTA
I low II low III high
33
kidney stones are assoc with which type RTA
I, distal
34
how do you differentiate between RTA and diarrhea as cause of HCO3 loss
urine anion gap if negative (more cations than anions) extrarenal loss high level NH4 if positive (more anions than cations) renal loss low level NH4
35
What are causes of respiratory alkalosis
pain, anxiety, salicylates overdose, fever, sepsis, hypoxia (CHF, pneumonia, PE), mild asthma, mechanical ventilation
36
what are causes of metabolic alkalosis
vomiting/NG suction contraction alkalosis from increased HCO3 reabsorption hypokalemia recent correction chronic resp acidosis
37
what are types of contraction alkalosis(increased HCO3) leading to metabolic alkalosis
dehydration, diuresis
38
increased mineralocorticoid secretion can lead to what imbalance with potassium and what broad metabolic acid base disorder
hypokalemia causing metabolic alkalosis
39
What are manifestations of metabolic acidoss
kussmaul respiration | nausea/vomiting, cardiac effects (arrhythmia and hypotension) neuro (confusion, lethargy, coma
40
what are manifestations of respiratory acidosis
ineffective respiration/respiratory distress cardiac effects: arrhythmia hypotension neuro: confusion, lethargy coma(hypercapnic, CO2 narcosis)
41
what are manifestations of metabolic alkalosis
decreased respiration neuro: paresthesia, carpopedal spasm, confusion, seizures, dizziness, coma weakness
42
what are manifestations of respiratory alkalosis
hyperventilation, deep (not kussmaul) neuro:paresthesia, dizziness symptoms of underlying disease
43
What are the 7 steps for reading ABG
1) look at pH above or below 7.4 2) look at HCO3 to determine if metabolic or respiratory (does it match pH) 3) determine if compensated or uncompensated, or partially 4) calculate anion cap to see if meatbolic acidosis 5) if have anion gap, calculate delta delta gap for mixed disorders 6) if metabolic look at pCO2 to determine if additional respiratory process exist 7) look at clinical picture
44
How do you calculate anion gap when patient has extremley high glucose
add 1 Na for every 100 mg/dl glucose
45
how do you calculate delta anion gap
(AG-10) / (24-HCO3) if 1-1.6 only metabolic acidosis if less than 1 concomitant non AG acidosis >1.6 concomitant metabolic alkalsosis
46
describe telling if additonal resp problem if a metabolic problem exists
see if pCO2 goes in same direction as pH if same, no resp if opp directions then additional respiratory
47
what is step 1 ABG
alkalosis vs acidosis
48
what is step 2 ABG
metabolic or respiratory? look at HCO3 and see if match pH
49
what are the midline numbers for ABG
pH 7.4 pCO2 40 HCO3 24
50
what is step 3 ABG
determine if compensated or uncompensated. Look at pH with metabolic!
51
What is step 4 ABG
anion gap
52
what is step 5 ABG
delta anion gap | AG-10)/(24-HCO3
53
what is step 6 ABG
if metabolic look at pCO2 to see if goes along or not with HCO3. if so no other resp disorder if against, another disorder skip if primary is respiratory
54
what is normal AG
10
55
what are delta gap interpretations
if 1-1.6 pure high AG metabolic acidosis(no other) if less than 1, concomitant non-AG acidosis If more than 1.6 concomitant metabolic alkalosis
56
If case is respiratory how do you calculate step 3 ABG--> compensation?
for each 10 mmHg increase pCO2 there is increase in HCO3 if HCO3 inc 1 mmole- no compensation 3-5 mmol-- compensation for each 10 mmHg decrease in pCO2 there is a dec in HCO3 1-1 mmol-- no compensation 5 mmol compensation

Year2 Renal (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions