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2 - CPR (renal) > Metabolic Acidosis/Alkalosis > Flashcards

Metabolic Acidosis/Alkalosis Flashcards

1
Q

HAGMA

A

High Anion Gap Metabolic Acidosis

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2
Q

What is the differential diagnosis pneumonic for HAGMA?

A

GOLDMARK

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3
Q

DDX for HAGMA

A

GOLDMARK

  • Glycols
  • Oxoproline
  • L and D Lactic Acidosis
  • Methanol
  • Aspirin
  • Renal failure
  • Ketoacidosis
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4
Q

DDX for HAGMA

A

GOLDMARK

  • Glycols
  • Oxoproline
  • L and D lactic acidosis
  • Methanol
  • Aspirin
  • Renal failure
  • Ketoacidosis
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5
Q

What DDX for HAGMA are differentials if the Osmolar Gap is increased?

A

Glycols

Methanol

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6
Q

NAGMA

A

Normal Anion Gap Metabolic Acidosis

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7
Q

What is the differential diagnosis pneumonic for NAGMA?

A

DURHAAM

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8
Q

DDX for NAGMA

A

DURHAAM

  • Diarrhea
  • Ureteral diversion
  • Renal Tubular Acidosis
  • Hyperalimentation
  • Acetazolamide
  • Addison’s disease
  • Misc.
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9
Q

DDX for NAGMA

A

DURHAAM

  • Diarrhea
  • Ureteral diversion
  • Renal Tubular Acidosis
  • Hyperalimentation
  • Acetazolamide
  • Addisons disease
  • Misc.
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10
Q

What defines Renal Tubular Acidosis (RTA)?

A

Net acid excretion by the kidneys is impaired

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11
Q

Net acid excretion by the kidneys is impaired

A

RTA

renal tubular acidosis

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12
Q

When can RTA NOT be diagnosed?

A

In the setting of AKI

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13
Q

What defines Distal RTA?

A

Decreased net H+ secretion in the distal tubules

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14
Q

Decreased net H+ secretion in the distal tubules

A

Distal (type 1) RTA

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15
Q

What 2 things may cause Distal RTA?

A

Sjogren’s syndrome

Sniffing glue

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16
Q

What is a common manifestation of Distal RTA?

A

Nephrolithiasis

17
Q

What is the result of the Urine Anion Gap with Distal RTA?

A

(+)

– unable to acidify urine

18
Q

What defines Proximal RTA?

A

Decreased net HCO3- reabsorption in the proximal tubule

19
Q

Decreased net HCO3- reabsorption in the proximal tubule

A

Proximal (type 2) RTA

20
Q

What 3 things may cause Proximal RTA?

A

Fanconi
Multiple myeloma
Cystinosis

21
Q

What is the result of the Urine Anion Gap with Proximal RTA?

A

(-)

22
Q

With Type 1 and Type 2 RTA, the urine pH is usually?

A

Less than 5.5

23
Q

With Type 1 and Type 2 RTA, what will the level of K+ be?

A

Hypokalemia

24
Q

What defines Type 4 RTA?

A

Decreased Aldosterone which causes decreased H+ and K+ secretion in the collecting duct

25
Q

Decreased Aldosterone that causes decreased H+ and K+ secretion

A

Type 4 RTA

26
Q

What 2 things may cause Type 4 RTA?

A

Diabetes

Drugs

27
Q

How will Type 4 RTA manifest?

A

Hyperkalemia

28
Q

With Type 4 RTA, what is the result of the Urine Anion Gap?

A

(+)

29
Q

With Type 4 RTA, the urine pH is usually?

A

Greater than 5.5

30
Q

What formula is used to calculate Urine Anion Gap?

A

(UrineNa + UrineK) - UrineCl

31
Q

If the Urine Anion Gap is (+) what does that conclude?

A

INappropriate distal nephron urinary acidification

32
Q

If the Urine Anion Gap is (-) what does that conclude?

A

Appropriate distal nephron urinary acidification

33
Q

A (-) Urine Anion Gap indicated an appropriate urinary acidification by being a surrogate marker of?

A

NH4Cl excretion

34
Q

What are 3 possible DDX for Metabolic Alkalosis?

A

Vomiting (volume depletion)
Diuretics (hypokalemia)
Mineralcorticoid excess

35
Q

What are 3 possible DDX for Metabolic Alkalosis?

A

Vomiting (volume depletion)
Diuretics (hypokalemia)
Mineralcorticoid excess

36
Q

Describe how Metabolic Alkalosis arises

A
  • Na reabsorption
  • Increased H+ secretion
  • Increased HCO3- reabsorption
    = Metabolic Alkalosis
37
Q

Describe how Metabolic Alkalosis arises?

A
  • Na+ reabsorption
  • Increased H+ secretion
  • Increased HCO3- reabsorption
    = Metabolic Alkalosis

2 - CPR (renal) (27 decks)

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