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CPR Exam 2 > Introduction to Acid-Base Disturbances and CIS-Wolff > Flashcards

Introduction to Acid-Base Disturbances and CIS-Wolff Flashcards

1
Q

compensation for A-B disturbance FASTEST to SLOWEST

A
  1. ECF buffering (with the enviornment)
  2. Cellular buffering (K+ out /H+ in exchange)
  3. Respiratory compensation
  4. Renal base (HCO-3) excretion
  5. Renal Acid (H+) excretion
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2
Q

high NH4+ in urine means what

A

a lot of H+ has been excreted

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3
Q

causes of Respiratory Acidosis ACUTE

A

CANS

  1. CNS depressed
  2. Airway obstructed
  3. Neuromuscular disorder
  4. severe pneumonia, pulmonary embolism, pulmonary edema
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4
Q

causes of Respiratory acidosis CHRONIC

A
  1. COPD
  2. impaired ventilation diseases (inhibition of medullary respiratory centers –X–> peripheral chemorecpetors, Guillain Barrè syndrome)
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5
Q

Respiratory Alkalosis

A

CHAMPS

  1. CNS causing hyperventilation
  2. Hypoxia (high altitude)
  3. Anxiety
  4. Pregesterone (stimulates medulla resp center)
  5. Salicylates (NSAIDS, Aspirin = acids causing increased breathing) Sepsis (esp gram-), severe anemia
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6
Q

what to calculate if you find metabolic acidosis

A 
Compensation 
Anion Gap (12 or under is normal)
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7
Q

what to calculate if you find metabolic alkalosis

A

Compensation (only not on test I think)

Cl- responsive or resistant or not (20 or under is normal)

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8
Q

Metabolic Acidosis causes WITH ANION GAP

A

HAGMA (GOLDMARK)

  1. Glycols (ethylene) **
  2. Oxoproline (Tylenol) **
  3. Lactic Acid ** (ISCHEMIA)
  4. D -Lactate (from carbs by bacteria in SI) = short bowel syndrome **
  5. Methanol
  6. Asprin, NSAIDS **
  7. Renal Failure **
  8. Ketoacidosis **
  9. Uremia
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9
Q

Metabolic Acidosis WITH NO anion gap

A

NAGMA (HARDUPS)

  1. Hyperalimentation (high Cl- )
  2. Acetazolamide
  3. RENAL TUBULAR ACIDOSIS **
  4. Diarrhea, V **
  5. Ureterosigmoid fistula (colon wastes HCO-3)
  6. Pancreatic fistula (eastes HCO-3)
  7. Spironolactone
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10
Q

Renal Tubular Acidosis is what

A

ACEDIMIA
+
normal Anion gap (nagma), serum Cr, and NO diarrhea

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11
Q

Type 1 Renal tubular acidosis

what , and exs

A

X secrete H+ from a-intercalated cells
= hypokalemia + normal AG
Sjögrens syndrome, Sickle cells anemia, liver cirrhosis)

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12
Q

Type 2 Renal tubular acidosis

what , and exs

A

X HCO3- reabsorption in PT
= hypokalemia
Fanconi’s syndrome (children), multiple myeloma, drugs

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13
Q

Type 4 Renal tubular acidosis

what , and exs

A

X aldosterone or kidney response to Aldosterone
= HYPERKALEMIA* (X K+ secreted and peed out= X H+ secreted out) + Normal AG
Diabetic nephropahty, chronic interstitial nephritis, drugs (NSAIDS, heparin)!!

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14
Q

What causes Metabolic Alkalosis

A

CLEVER PD

  1. Contraction of ECF (loss of NaCl)
  2. Licorice
  3. Endocrine problem (Cushing, Conns, Bartter)
  4. Vomit (loose HCl, form tummy)
  5. Post- hypercapnia
  6. diuretics –> K+ loss and H+ loss = volume contraction
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15
Q

HTN

A

high H+

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16
Q

Hypotention

A

HIGH HCO-3

17
Q

cause and TX of Cl- responsive metabolic alkalosis

A

V, diuretics,

Tx: normal saline with Cl-

18
Q

cause and TX of Cl- restrictive metabolic alkalosis

A 
HIGH aldosterone (RTA) = increased H+ and K+ excretion  and NaCl, NaHCO3 reabsoption, diuretics
Tx: cause of this Cl- in urine loss (hyperaldosteronism, K+ loosing diuretics)
19
Q

Patient with Respiratory Acidosis ACUTE will present with

A

headache, confusion, anxiety, tremor, coma maybe, convulsions, drowsy

20
Q

Patient with Respiratory Acidosis CHRONIC will present with

A

COPD
memory loss, sleep loss, sleepy during day, personality changes, tremor, gait changes, loss of reflex, papilledema, twitching

21
Q

Patient with Respiratory Alkalosis ACUTE will present with

A

light-headed, confusion, paresthesia (numbness and tingling), cramps, syncope, tachypnea*, hypocalcemia (decreases threshold for AP)

22
Q

Patient with Respiratory Alkalosis CHRONIC will present with

A

asymptomatic usually

23
Q

Patient with Metabolic Acidosis MILD will present with

A

asymptomatic usually

24
Q

Patient with Metabolic Acidosis pH< 7.10 will present with

A

N, V, malaise

= respiratory compensation seen : DEEP breaths (X DYSPNEA)

25
Q

Patient with Metabolic Alkalosis MILD will present with

A

Vomiting

26
Q

Patient with Metabolic Alkalosis SEVERE will present with

A

HYPOCALCEMIA

= headache, lethargy, seizures, delirium, tetany, arrhythmia

27
Q

lactic acid can build up in body due to what

A

ischemia in a limb or part of body

28
Q

Respiratory Acidosis + metabolic acidosis with ANION GAP can happen from what

A

respiratory problem like pneumonia, and lactic acid build up from peripheral ischemia

29
Q

Respiratory alkalosis + Metabolic Acidosis with NO anion gap

A

hyperventilation, and V/D

CPR Exam 2 (22 decks)

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