Lecture 14 10/24/24 Flashcards
What are the causes of metabolic acidosis?
-gain an acid
-lose a base
What are the causes of metabolic alkalosis?
-lose an acid
-gain a base
What is the cause of resp. acidosis?
retain pCO2
What is the cause of resp. alkalosis?
lose pCO2
Which acids can be gained to cause metabolic acidosis?
any acid other than pCO2
Which base can be lost to cause metabolic acidosis?
bicarbonate
What are the terms for metabolic acidosis in which acid is gained?
-titration metabolic acidosis
-high AG metabolic acidosis
What are the terms for metabolic acidosis in which base is lost?
-bicarbonate loss acidosis
-hyperchloremic metabolic acidosis
What are some examples of titration metabolic acidosis?
-lactic acidosis
-renal/uremic acidosis
-ketoacidosis
-ethylene glycol toxicity
What are some examples of bicarbonate loss acidosis?
-diarrhea
-renal tubular dysfunction
-compensatory response to resp. alkalosis
What are the characteristics of titration metabolic acidosis?
-always primary
-gaining an acid leads to titration of HCO3-
What is the blood gas pattern seen with titration metabolic acidosis?
-increased anion gap
-decreased HCO3-
-normal Cl
What are the characteristics of bicarbonate loss acidosis?
-losing HCO3- promotes retention of Cl-
-retention maintains electroneutrality
What is the blood gas patten seen with bicarbonate loss acidosis?
-decreased HCO3-
-increased Cl-
-normal anion gap
What are the characteristics of K+ and metabolic acidosis?
-hyperkalemia can occur with some types of metabolic acidosis
-most commonly seen with renal acidosis and HCO3- loss acidosis
Which acid is lost to cause metabolic alkalosis?
HCl
Which base is gained to cause metabolic alkalosis?
bicarbonate
What can lead to primary metabolic alkalosis?
losing an acid:
-vomiting
-sequestration of HCl
gaining a base:
-iatrogenic bicarbonate administration
What can lead to compensatory metabolic alkalosis?
-primary respiratory acidosis
-kidney can excrete H+ and resorb HCO3-; losing acid while gaining base
What is the blood gas pattern seen with metabolic alkalosis?
-increased HCO3-
-decreased Cl- (with low Na+)
-normal anion gap
How does metabolic alkalosis impact K+?
K+ is normal or decreased
What are the mechanisms behind decreased K+ in metabolic alkalosis?
-movement from ECF to ICF
-aldosterone (causes Na+ resorption and K+ secretion)
-decreased intake if anorexia occurs
What is the appropriate renal response to metabolic alkalosis?
-retain acid from urine and/or
-excrete base into urine
What is paradoxic aciduria?
metabolic alkalosis with acidic urine
What are the predisposing factors for paradoxic aciduria?
-metabolic alkalosis
-hypovolemia
-potassium depletion
What physical action leads to respiratory acidosis?
hypoventilation (increased pCO2)
What are the potential causes of primary resp. acidosis?
-CNS disorder
-restrictive pulmonary disease
-severe pneumonia
-anesthesia with poor ventilation
What causes a compensatory resp. acidosis?
metabolic alkalosis
What physical action leads to respiratory alkalosis?
hyperventilation ( decreased pCO2)
What are the potential causes of primary resp. alkalosis?
-panting
-pain
-pneumonia
-anesthesia with excessive ventilation
What causes a compensatory resp. alkalosis?
metabolic acidosis
