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Supporting life block > Metabolic acidosis > Flashcards

Metabolic acidosis Flashcards

1
Q

What should arterial pH be maintained at?

A

7.35-7.45

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2
Q

What should intracellular pH be maintained at?

A

7-7.3

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3
Q

Which organs work together to control body pH

A

Lungs& kidney

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4
Q

List the different acid base disorders

A
  • Metabolic acidosis
  • Metabolic alkalosis
  • Respiratory acidosis
  • Respiratory alkalosis
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5
Q

What are the characteristics(pH, primary disturbance& compensatory response) of Metabolic acidosis

A

pH= low
primary disturbance= low bicarbonate ion( HCO3-)
compensatory mechanism= decreased PCO2( so hyperventilation occurs)

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6
Q

What are the characteristics(pH, primary distrubance& compensatory response) of Metabolic alkalosis

A

pH=high
primary disturbance= increased concentration of bicarbonate ion
Compensatory response= increased PCO2 so hypoventilation occurs

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7
Q

What are the characteristics(pH, primary distrubance& compensatory response) of respiratory acidosis

A

pH=low
primary disturbance= increased pco2
Compensatory response= increased concentration of bicarbonate ion

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8
Q

What are the characteristics(pH, primary distrubance& compensatory response) of respiratory alkalosis

A

pH=high
primary disturbance= reduced pco2
Compensatory response= readuced concentration of bicarbonate ion

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9
Q

What is metabolic acidosis

A

-A low arterial blood pH in conjuction with a reduced serum HCO3- conc.

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10
Q

What is the normal range for serum bicarbonate ion conc.?

A

24-26mmol/L

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11
Q

What is the anion gap?

A
  • Usually around 8-12mmol/L
  • The difference between the primary measured cations(na+ and k+) and the primary measured anions( Cl- and HCO3-)
  • Determines the presence of metabolic acidosis
  • Since there are more unmeasured anions than unmeasured cations, the value of anion gap is usually positive.
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12
Q

What can we say about the neutrality of plasma with regards to the anion gap?

A
  • Plasma is always electroneutral

- Measured cations+ unmeasured cations=measured anions+ unmeasured anions

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13
Q

What does an increased anion gap indicate?

A

-An increase in the concentration of anions other than chloride or bicarbonate

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14
Q

What is the clinical correlation with the anion gap?

A

-The anion gap identifies an abnormal increase in plasma anions

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15
Q

Outline the increased anion gap acidosis

A
  • Caused by increased amount of organic acids
  • The h+ ions are buffered by bicarbonate ions
  • The negatively charged organic acid component e.g lactate ion contributes to the proportion of unmeasured anions, resulting in an increased anion gap.
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16
Q

Outline the normal anion gap acidosis

A
  • Loss of bicarbonate ions
  • Kidney compensates by increasing reabsorption of chloride ions
  • cL- ions are included in our anion gap calculation so anion gap remains normal and plasma remains electroneutral
  • May also be referred to as hyperchloraemic acidosis
  • The serum is acidotic cos there are fewer bicarbonate ions to buffer the hydrogen ions
17
Q

What causes normal anion gap acidosis?

A
  1. ) GI losses of bicarbonate:
    - diarrhoea
    - surgical drains/fistulae
  2. ) Renal losses of bicarbonate:
    - renal tubular acidosis( may be caused by decreased bicarbonate reabsorption in the distal convuluted tube
18
Q

Why doesnt vomiting usually cause acidosis?

A

-Cos even though there is loss of bicarbonate, there is also loss of hydrogen ions from gastric acid.

19
Q

What is the cause of increased anion gap acidosis?

A 
pneumonic GOLDMARK
Glycols(ethylene, propylene)
Oxyproline
Lactate (lactic acidosis- salicylates/shock)
D-lactate
Methanol poisoning 
Aspirin
Renal failure
Ketoacidosis (diabetics)
20
Q

What is lactic acidosis and what causes it?

A
  • Result of lactate production- anaerobic respiration
  • Caused by shock:
    1. )hypovolaemic
    2. ) cardiogenic
    3. )anaphylactic
    4. ) septic
21
Q

What is ketoacidosis and what causes it?

A
  • Result of ketone production, fat metabolism

- Main causes: diabetes, starvation and alcohol

22
Q

What is the desired range for arterial pH ?

A

7.35-7.45

23
Q

What is the desired range for paco2 ?

A

4.5-6kPa

24
Q

What is the desired range for pao2 ?

A

10-13kPa

25
Q

What is the desired range for HCO3- ?

A

24-26mmol/L

26
Q

What is the desired range for o2 sat?

A

96-100%

27
Q

What is the desired range for base excess?

A

+/- 2 mEq/L

28
Q

How is respiratory acidosis/alkalosis compensated for

A

Renal compensation(metabolic)

29
Q

How is metabolic acidosis/alkalosis compensated for

A

Respiratory compensation

Supporting life block (28 decks)

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