Flash Notes Miscellaneous - Acid Base Disorders

Question 1

what is a simple acidosis/alkalosis? what compensatory process is seen?

Answer 1

one primary change occurs in the same direction of the pH (loss or gain of an acid/base) when present - a secondary change in the opposite direction to pH but overcompensation does not occur!!!!!

Question 2

what changes are seen in pH, H+, primary change, & compensatory response in a respiratory acidosis?

Answer 2

pH: decreased, H+: increased, primary change: increased pCO2, & compensatory response: increased HCO3

Question 3

what changes are seen in pH, H+, primary change, & compensatory response in a respiratory alkalosis?

Answer 3

pH: increased, H+: decreased, primary change: decreased pCO2, & compensatory response: decreased HCO3

Question 4

what changes are seen in pH, H+, primary change, & compensatory response in a metabolic acidosis?

Answer 4

pH: decreased, H+: increased, primary change: decreased HCO3, & compensatory response: decreased pCO2

Question 5

what changes are seen in pH, H+, primary change, & compensatory response in a metabolic alkalosis?

Answer 5

pH: increased, H+: decreased, primary change: increased HCO3, & compensatory response: increased pCO2

Question 6

how do compensatory responses differ in acute & chronic acid/base disorders?

Answer 6

compensatory changes will be greater in chronic diseases

Question 7

what categorizes a respiratory acidosis?

Answer 7

increased levels of carbon dioxide

Question 8

what are some causes of respiratory acidosis due to hypoventilation?

Answer 8

decreased elimination of CO2 - respiratory tract dysfunction (upper airway obstruction, lower airway pulmonary/thoracic dz, muscle weakness causing a decreased tidal volume, & atelectasis from recumbency/obesity)

Question 9

what are some causes of respiratory acidosis due to dysfunction of respiratory centers in the brain?

Answer 9

anesthesia/sedation (resets threshold at higher pCO2) & cerebral disease

Question 10

what are some examples of how an increased production of CO2 overwhelms ventilation causing a respiratory acidosis?

Answer 10

malignant hyperthermia resulting in an abnormal muscle metabolism, heat stroke, & lactic acidosis

Question 11

what are the 3 main ways a metabolic acidosis occurs?

Answer 11

1. compensation for respiratory alkalosis 2. due to loss of HCO3 & 3. increased acid/titration acidosis

Question 12

what is seen in a metabolic acidosis due to loss of HCO3? what are some common causes?

Answer 12

hyperchloremic normal anion gap acidosis - kidney resorbs Cl with Na to restore volume so an increase in Cl is seen & increased Cl balances the AG equation (HCO3 & Cl are measured anions)

Question 13

how does renal loss result in a metabolic acidosis?

Answer 13

tubular acidosis & addison’s disease

Question 14

what is titration acidosis? what can cause it?

Answer 14

high anion gap normochloremic acidosis with organic acids buffered by bicarbonate - increase in uremic acids with renal failure, ketoacidosis, antifreeze poisoning

Question 15

what is the likely cause of an increased anion gap with normal chloride?

Answer 15

increase in levels of unmeasured anions

Question 16

what is the likely cause of a decreased anion gap with high chloride?

Answer 16

loss of bicarbonate

Question 17

what are some causes of an elevated lactic acid that causes a metabolic acidosis?

Answer 17

tissue hypoxia with anaerobic metabolism due to increased lactate, decreased tissue perfusion (hypovolemia, hypotension/vasodilation, sepsis, heart failure, cardiac arrest)

Question 18

how does rumen acidosis result in a metabolic acidosis?

Answer 18

grain overload - increased production of L form of lactic acid, sometimes d-lactate, often hypovolemic/dehydrated as well

Question 19

how does hyperthermia result in a metabolic acidosis?

Answer 19

severe anemia, heat stroke, excessive exercise especially if unfit (get too hot)

Question 20

how does hyperproteinemia/globinemia cause a metabolic acidosis?

Answer 20

many proteins are weak acids due to presence of histidine in side chains identified with physiochemical theory of a/b - plasma cell myeloma, chronic infection, neoplasia

Question 21

how does hyperventilation result in a respiratory alkalosis?

Answer 21

excitement/anxiety/fear/warm environments, common in small animals - panting

Question 22

what are some examples of causes of how loss of H+ & Cl results in a metabolic alkalosis?

Answer 22

vomiting in small animals, gastric reflux in horses (HCl production continues & generates NaHCO3, so H- & Cl- are lost but HCO3 is retained), upper gi obstruction especially in ruminants (choke - displaced/torsed abomasum causes sequestration of H & Cl), kidney saves HCO3, Cl is not available to resorb with sodium

Question 23

what are some causes of increased excretion/loss of Cl that result in a metabolic alkalosis?

Answer 23

sweating/exertional rhabdomyolysis (lose lots of Cl, K, Ca, Na) & diuretic therapy (loop of henle type: furosemide causes loss of Na, Cl, & K, or thiazide type: lose Na & Cl)

Question 24

what are some causes of increased sodium levels that result in a metabolic alkalosis?

Answer 24

hyperaldosteronism & hyperadrenocorticism

Question 25

T/F: acidosis appears less severe in diseases with protein loss

Answer 25

TRUE

Question 26

how is hypoproteinemia involved in causing a metabolic alkalosis?

Answer 26

many proteins are weak acids & aren’t apparent with traditional a/b principles - important component of strong ion theory & usually hidden unerlying a/b abnormality