Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

renal > metabolic acidosis > Flashcards

metabolic acidosis Flashcards

1
Q

causes of metabolic acidosis (4)

A
  1. addition of acid
  2. reduction/ loss of bicarbonate
  3. inability to properly excrete H ions
  4. inability to appropriately restore bicarbonate buffer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

some affects of chronic metabolic acidosis

A
  • bone disease
  • reduced albumin synthesis
  • increased muscle wasting
  • acceleration of kidney disease
  • impaired glucose tolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

adverse effects of acute metabolic acidosis

A
  • impaired leukocyte function
  • changes in mental status
  • stimulation of apoptosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

4 homeostatic response to an acid load

A
  1. immediate- extracellular buffering by HCO3
  2. minutes to hours: respiratory buffering by lowering pCO2
  3. two to four hr- intracellular and bone buffering
  4. hours to days- increased renal H+ excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how is the respiratory compensation for metabolic acidosis

A

important and rapid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

anion gap

  • what is it?
  • nl range
A
  • measured sodium and cl- and HCO3-
  • nl: 8-12
  • mostly made up albumin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

addition of an organic acid; what happens to the anion gap

A

rises H+ and thus there is a drop in HCO3

  • increase in anion gap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

addition of mineral acid

A

rise in H+ and there is a decrease in bicarb but there is no drop in anion gap

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

examples of an organic acid

A

lactic acid, ketoacids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

examples of a mneral acid

A

hydrochloric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

exaplain the difference in hydrogen load btwn organic and mineral

A
  • organic: there is increase in unmeasured acid but cl- stays constant
  • there is an increase in cl- and a decrease in unmeasured acid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

example of a process that leads to a nl anion gap

A
  • loss of bicarb due to diarrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

impaired acid excretion examples

A
  • renal failure

- distal (type 1) RTA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

increased anion gap in mechanism of acidosis

A
  • lactic acidosis
  • ketoacidosis: diabetes mellitus, starvation, alcohol associated
  • ingestions: aspirin, methanol
  • chronic kidney disease stages 4-5
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

normal anion gap in metabolic acidosis

A
  • diarrhea
  • early chronic kidney disease
  • proximal/distal RTA
  • intestinal, pancreatic or billiary fistula
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

bicarb is reclaimed in

A

proximal tubular cell by CO2 intermediate

17
Q

excrete H+ ions in the form of

A

tritratable acid

18
Q

secrete H+ ions in the distal nephron to make the

A

NH3 into NH4+

19
Q

chronic kidney disease is where we have a decreased in

A

acid excretion

20
Q

what is wrong in chronic kidney disease

A

loss of functioning nephrons leads to a disruption in acid base balance where intially it is mantained by increased ammonium ecretion but eventually you see a decrease in bicarb and increase in unmeasured anion concetration

21
Q

stage 2-3 CKD we see an anion gap that is

A

normal

22
Q

stage 4-5 CKD we see an anion gap that is

A

high

23
Q

distal (type 1) renal tubular acidosis

A

inability to decrease urine pH < 5.5-6.0 due to decrease hydrogen ion secretion

24
Q

common mechanism of distal (type 1) renal tubular acidosis

A

impaired apical H+-ATPase pump

25
Q

proximal (type 2) renal tubular acidosis

A

impaired bicarb reabsorption by the proximal tubule which leads to urinary bicarb loss until the lower resportive capcity is reached and once all of the filtered bicarb is reabsorbed

26
Q

lactic acid mechanism (2)

A
  1. increased lactate production: alterd redox state/pyruvate
    - decreased lactate utilization
27
Q

primary goal for lactic acidosis treatment

A
  • restore perfusion which leads to decrease lactate production and enable hepatic metabolism of lactate to HC)3
28
Q

diabetic ketoacidosis is both a

A

insulin deficiency and glucagon excess

29
Q

consequences of Diabetic ketoacidosis

A

hyperglycemia and hyperosmolarity

  • wee see a loss of hypotonic fluids and loss of ketoacid anions
30
Q

treatment of diabetic ketoacidosis

A
  • insulin therapy
  • volume resucitation
  • potassium replacement
  • careful bicarb replacement
31
Q

metabolic acidosis from diarrhea leads to

A

non-anion gap

32
Q

diarrhea treatment

A
  • bicarb replacement
  • volume resuscitation
  • correction of hypokalemia and other electrolyte disturbances

renal (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions