Flash Notes Miscellaneous - Acid Base Disorders Flashcards
what is a simple acidosis/alkalosis? what compensatory process is seen?
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!!!!!
what changes are seen in pH, H+, primary change, & compensatory response in a respiratory acidosis?
pH: decreased, H+: increased, primary change: increased pCO2, & compensatory response: increased HCO3
what changes are seen in pH, H+, primary change, & compensatory response in a respiratory alkalosis?
pH: increased, H+: decreased, primary change: decreased pCO2, & compensatory response: decreased HCO3
what changes are seen in pH, H+, primary change, & compensatory response in a metabolic acidosis?
pH: decreased, H+: increased, primary change: decreased HCO3, & compensatory response: decreased pCO2
what changes are seen in pH, H+, primary change, & compensatory response in a metabolic alkalosis?
pH: increased, H+: decreased, primary change: increased HCO3, & compensatory response: increased pCO2
how do compensatory responses differ in acute & chronic acid/base disorders?
compensatory changes will be greater in chronic diseases
what categorizes a respiratory acidosis?
increased levels of carbon dioxide
what are some causes of respiratory acidosis due to hypoventilation?
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)
what are some causes of respiratory acidosis due to dysfunction of respiratory centers in the brain?
anesthesia/sedation (resets threshold at higher pCO2) & cerebral disease
what are some examples of how an increased production of CO2 overwhelms ventilation causing a respiratory acidosis?
malignant hyperthermia resulting in an abnormal muscle metabolism, heat stroke, & lactic acidosis
what are the 3 main ways a metabolic acidosis occurs?
- compensation for respiratory alkalosis 2. due to loss of HCO3 & 3. increased acid/titration acidosis
what is seen in a metabolic acidosis due to loss of HCO3? what are some common causes?
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)
how does renal loss result in a metabolic acidosis?
tubular acidosis & addison’s disease
what is titration acidosis? what can cause it?
high anion gap normochloremic acidosis with organic acids buffered by bicarbonate - increase in uremic acids with renal failure, ketoacidosis, antifreeze poisoning
what is the likely cause of an increased anion gap with normal chloride?
increase in levels of unmeasured anions
what is the likely cause of a decreased anion gap with high chloride?
loss of bicarbonate
what are some causes of an elevated lactic acid that causes a metabolic acidosis?
tissue hypoxia with anaerobic metabolism due to increased lactate, decreased tissue perfusion (hypovolemia, hypotension/vasodilation, sepsis, heart failure, cardiac arrest)
how does rumen acidosis result in a metabolic acidosis?
grain overload - increased production of L form of lactic acid, sometimes d-lactate, often hypovolemic/dehydrated as well
how does hyperthermia result in a metabolic acidosis?
severe anemia, heat stroke, excessive exercise especially if unfit (get too hot)
how does hyperproteinemia/globinemia cause a metabolic acidosis?
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
how does hyperventilation result in a respiratory alkalosis?
excitement/anxiety/fear/warm environments, common in small animals - panting
what are some examples of causes of how loss of H+ & Cl results in a metabolic alkalosis?
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
what are some causes of increased excretion/loss of Cl that result in a metabolic alkalosis?
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)
what are some causes of increased sodium levels that result in a metabolic alkalosis?
hyperaldosteronism & hyperadrenocorticism
T/F: acidosis appears less severe in diseases with protein loss
TRUE
how is hypoproteinemia involved in causing a metabolic alkalosis?
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
