More Acid Base Flashcards
Clinical signs up upper GI obstruction/Dz
Dehydration
Hypokalemia
Loss of HCl
What acid Base disturbance does upper GI obstruction/ reflux/ vomiting usually
Cause
Metabolic alkalosis (If hypokalemia will get paradoxical aciduria)
Anion gap formula
(Na+ K) - (Cl+HCO3)
Which is typically greater measured cations or anions ?
Cations
Na K > Cl HCO3
Which is typically greater unmeasured anions or cations
Anions
Ie albumin phosphates ketones uremic toxins lactate > Ca Mg
Examples of unmeasured anions
Albumin P Ketones Uremic toxins Lactate Ect
Causes/ differential of high anion gap (titrational acidosis - inc acids that neutralize HCO3)
PSKULE
Phosphates Sulfates Ketones Uremic acids Lactic acids Ethylene glycol
Acidosis with a high anion gap
Titrational
Ie addition of excess acid
Acidosis with normal anion gap
Bicarbonate loss (Secretional acidosis)
Changes to Cl seen with bicarbonate loss
Increase Cl
Changes to Cl seen with increased acid/bicarbonate neutralization
Cl stays the same
Causes of secretional acidosis
Loss of bicarbonate rich fluid (Secretional diariah or sequestration)
Renal tubular acidosis
(impaired reabsoption of HCO3/ secretion of H = more Cl reabsorption / decreases secretion of Cl
Loss of saliva (ruminants)
Cause decrease bicarbonate and increased Cl =
Normal anion gap
Most common cause of low anion gap (not clinically significant)
Hypoalbunemia
Examples of mixed acidosis/alkalosis disorder
High GI obstruction with lactic acid via shock
HCL sequestration= metabolic alkalosis with hypochloremi w/normal-inc bicarb
Lactic acidosis buildup = inc anion gap = titrational metabolic acidosis
Renal failure with vomiting and uremic toxin buildup
Vomit = HCl loss = metabolic alkalosis with hypocloremia
Uremic toxin = inc anion gap = titrational metabolic acidosis
