Part 2 acid base

Question 1

When body lacks oxygen body will go into metabolism without oxygen thats called anaerobic metabolism

Question 2

Anaerobic metabolism will generate ___________

Answer 2

lactate

Question 3

Lactic acidosis is greater than 4 to 5mEq/L

Question 4

Which pts will develop lactic acidosis? whenever pt has _________

Answer 4

breathing difficulty

Question 5

_______________ is a perfect example your not able to a get adequate amount of oxygen so you go into anaerobic metabolism so you generate lactate. Lactate is an acidic substance and pt may develop metabolic acidosis

Answer 5

respiratory failure

Question 6

If pt is in metabolic acidosis and we calculate anion gap and its okay then its normal anion gap metabolic acidosis

Question 7

Metabolic acidosis primary disorder is your losing what?

Answer 7

bicarbonate

Question 8

How can you lose bicarbonate? through GI loss like ______ or through renal loss (kidney)

Gain of exogenous sources of chloride (ingesting too much chloride)

Answer 8

diarrhea we lose bicarbonate

Question 9

How can you get alot of chloride outside of the body? maybe your given too much ___________

Answer 9

normal saline infusion

Question 10

The body maintains a ratio HCO3/Cl greater than or equal to 0.25

Question 11

If you have too much saline infusion you may develop metabolic acidosis which is called ________metabolic acidosis (too much chloride )

Answer 11

hyperchloremic metabolic acidosis

Question 12

If pt develops hyperchloremic metabolic acidosis from normal saline infusion what do we give the pt?

Answer 12

lactated ringers which has less sodium chloride. Lactate ringers can help with acidosis…lactate metabolizes to bicarbonate so we are increasing a little bit of bicarbonate

Question 13

If pt is in metabolic acidosis then you need to calculate anion gap if its high then could be due m.u.d.p.i.l.e.s

Question 14

If gap is normal so normal anion gap metabolic acidosis which is due to what? pt having _________, losing bicarbonate through kidney, or infusing too _________to the pt

Answer 14

diarrhea

saline

Question 15

Kidney not only regulate bicarbonate but secretes hydrogen ions

Question 16

_______(RTA)=impaired ability to excretion of hydrogen ion into urine

Answer 16

Renal tubular acidosis

Question 17

acidosis could be due to damage of renal tubules

Question 18

________-Type 1: a defect in H+ secretion in the distal tubule

Answer 18

Distal RTA

Question 19

________-Type II (Fanconi syndrome)
-Renal bicarbonate wasting
-impaired HCO3 reabsorption in the proximal tubule

Answer 19

Proximal RTA

Question 20

__________: Impairment in ammonia synthesis in the distal tubule-essential for H+ secretion

Answer 20

Type IV distal