Lecture 14 - Acid Base

Question 1

What does the kidney do to compensate for acidic respiratory issues

Answer 1

Put HCO3 in blood

Put H+ in urine

Question 2

How does the kidney do for respiratory alkalosis

Answer 2

HCO3 into urine

H+ into blood

Question 3

where are the peripheral chemoreceptors

Answer 3

Aortic arch

carotid body

Question 4

What are peripheral chemoreceptors sensitive to

Answer 4

changes in O2, CO2, and H+

Question 5

How does the respiratory system compensate for decreased ph

Answer 5

RR increases, more CO2 blown off, PaCO2 decreases and arterial pH increases

Question 6

What are the steps for evaluating acid/base disturbances

Answer 6

1. Is the pH within 7.35 to 7.45
2. Respiratory if CO2 and pH change in opposite directions
   Metabolic if pH and HCO3 change in the same direction
3. Is the problem acute or chronic
   Acute if ΔHCO3 = 1 for every 10 mm Hg change in CO2
   Chronic if ΔHCO3 = 3-4 for every 10 mm Hg change in CO2

Question 7

What is the anion gap? When should you calculate it

Answer 7

The difference between cations and anions; metabolic acidosis

Anion gap = Na - Cl - HCO3

Question 8

What is a normal anion gap

Answer 8

6-12

Question 9

What can cause elevated anion gaps

Answer 9

MUDPILES

Methanol
Uremia
Diabetic ketoacidosis *
Paraldehyde
Isoniazid or Iron
Lactic acidosis *
Ethylene glycol or ethanol
Salicylates *

Question 10

How do you calculate osmolarity? what is normal

Answer 10

Osmolatrity = (2*serum Na) + (BUN/2.8) + (glucose/18)

290 mOsmoles/L