Final Quiz: Acid-Base

Question 1

Normal blood pH

Answer 1

7.35-7.45

Question 2

Normal HCO3

Answer 2

22-28

Question 3

Normal pCO2

Answer 3

35-45

Question 4

Organ responsible for Bicarb

Answer 4

Kidney

Question 5

Organ responsbile for C02

Answer 5

Lungs

Question 6

Anion Gap equation

Answer 6

AG = ( Na + K ) - ( Cl + HCO3)

Question 7

Anion Gap utilization

Answer 7

If AG > 14, suspect exogenous/endogenous factor present.

Question 8

Primary disturbance in Metabolic Acidosis

Answer 8

Low HCO3

Question 9

Primary disturbance in Respiratory Acidosis

Answer 9

High PaCO2

Question 10

Management: Acute Resp. Acidosis

Answer 10

Severe - mechanical vent

Due to bronchospasm - bronchodilator
Due to overdose - antagonize

Question 11

Benzodiazepine antagonist

Answer 11

Flumazenil

Question 12

Opioid antagonist

Answer 12

Naloxone

Question 13

Management: Chronic Resp. Acidosis

Answer 13

O2 only if necessary - careful

Bicarb if pH < 7.2
- Treat to pH 7.25

Question 14

Management: Acute Resp. Alkylosis

Answer 14

Correct cause
Severe hypoxemia - Oxygen
Mechanical vent. if pH > 7.6

Question 15

Management: AG Metab. Acidosis

Answer 15

Correct cause

Question 16

Management: Non-AG Metab. Acidosis

Answer 16

Bicarb up to 18

Question 17

Causes of Non-AG Metab. Acidosis

Answer 17

GI Losses, Urine-AG (-)
Renal Losses, Urine-AG (+)
- RTA

Question 18

Management: Severe Metab. Acidosis

Answer 18

Bicarb up to 18

• pH < 7.15
• HCO3 < 5

Question 19

Management: Chronic Metab. Acidosis

Answer 19

Treat cause

Oral bicarb. or alkali therapy

Question 20

Management: Saline-responsive Metabolic Alkylosis with U [Cl] < 10

Answer 20

If vomiting: anti-emetic
If NG suction: put H2-blockers in there
If diuretic: D/C or lower dose

Then give NS or 1/2 NS

Question 21

Management: Severe/prolonged Metabolic Alkylosis

Answer 21

If pH > 7.55, give ammonium-Cl

- Give HCl if life-threatening, liver disease, or can’t be dialyzed.

Question 22

Urine Anion Gap Equation

Answer 22

AGu = ( Na,u + Ku ) - Clu

Question 23

Proximal RTA: Type II

Answer 23

Proximal struggles to bring Bicarb. back in.
New equilibrium 15-17
Acetazolamide a big one

Question 24

Distal RTA: Type I

Answer 24

Distal can push H+ out and bring Bicarb. in.
More mild than Type II
Acetazolamide and Amiloride big ones

Question 25

Type IV RTA

Answer 25

Ultimately aldosterone insufficient

ACEs/ARBs, spironolactone