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REGUB > L3: Acid-Base Disorders > Flashcards

L3: Acid-Base Disorders Flashcards

1
Q

What is the normal pH of the body? What is the [H+] at this pH?

A 
pH = 7.4
[H+] = 40 nmol/L
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2
Q

In the body, for every 0.3 pH change, how much does the [H+] change by?

A

a factor of 2

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3
Q

If there is increased acid production which exceeds the normal carbonic anhydrase buffering system, buffering can be done by: [3]

A
  1. bone
  2. haemoglobin
  3. plasma proteins
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4
Q

What are the 3 important values when examining acid:base disorders?

A
  1. HCO3-
  2. CO2
  3. pH
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5
Q

If HCO3-, CO2 and pH all move in the SAME direction, what type of acid base disorder is this?

A

Metabolic (primary problem usually HCO3-)

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6
Q

If HCO3-, CO2 and pH move in DISCORDANT directions, what type of acid base disorder is this?

A

Respiratory (primary problem usually CO2)

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7
Q

What is the normal value of pCO2 in the body?

A

5.3

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8
Q

What is the normal value of HCO3- in the body?

A

24

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9
Q

What is the significance of Winter’s formula? What is Winter’s formula?

A
  • to examine respiratory compensation in metabolic acidosis
  • gives an expected value for the patients’ PCO2

pCO2 = (HCO3/5) + 1

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10
Q

What is the normal anion gap range?

A

8-12

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11
Q

What is the formula for anion gap?

A

Anion Gap = Na+ - (Cl + HCO3)

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12
Q

What does it mean if there is a high anion gap?

A

it indicates the presence of more anions than cations - suggesting acidosis

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13
Q

What is the general principle behind Normal Anion Gap Metabolic Acidosis?

A
  • HCO3 decreases
  • Cl- increases
    (anions unchanged)
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14
Q

What is the general principle behind Increased Anion Gap Metabolic Acidosis?

A
  • HCO3 decreases
  • anions increase
    (Cl- unchanged)
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15
Q

What are the 3 main causes of normal anion gap metabolic acidosis (NAGMA)?

A
  1. Chloride Intoxication
  2. GI Loss of HCO3- (diarrhea)
  3. Renal Loss of HCO3- (renal tubular acidosis)
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16
Q

What is renal tubular acidosis?

A

acidosis occurs due to reabsorption of HCO3- being impaired

17
Q

List the 4 differential diagnoses/possible causes of increased anion gap metabolic acidosis

A
  1. Lactic Acidosis
  2. Renal Failure
  3. Ketoacidosis
  4. Poisonings
18
Q

What is Type A and Type B lactic acidosis?

A

Type A = Tissue Hypoxia

Type B = Mitochondria Failure

19
Q

How does renal failure lead to increased anion gap metabolic acidosis?

A

Renal Failure - fail to excrete daily acid intake

  • lowering of HCO3 set point to 18 mmol/L [DECREASE IN HCO3]
  • inability to secrete anions from kidney [INCREASE OF ANIONS]
20
Q

What is the treatment of alcoholic ketoacidosis? What should the patient NOT be treated with?

A
  1. Glucose
  2. B Vitamins

SHOULD NOT BE GIVEN INSULIN

21
Q

What does Fomepizole injections used for?

A
  • alcohol poisoning
  • blocks alcohol dehydrogenase
  • used if there is a high osmolar gap
22
Q

What is the possible treatment for methanol poisoning?

A
  1. Fomepizole Injection

2. Folate (B9)

23
Q

In general, what are the possible treatment options for poisonings? [4]

A
  • isotonic sodium bicarbonate
  • fomepizole (if osmolar gap)
  • dialysis if elevated toxic alcohol
  • B vitamins
24
Q

What is another name for vitamin B1?

A

Thiamine

25
Q

What is another name for vitamin B6?

A

Pyridoxine

26
Q

What is another name for vitamin B9?

A

Folate/Folic Acid

27
Q

How can aspirin cause a metabolic acidosis?

A

can cause lactic acidosis (therefore can cause an increase AG metabolic acidosis)

28
Q

What is another name for aspirin? (formal name)

A

acetylsalicylic acid or salicylic acid / salicylate

REGUB (22 decks)

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