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All the Small Things > Phys Review > Flashcards

Phys Review Flashcards

1
Q

Gut related acidosis produces what sort of urine anion gap?

A

Negative (neGUTive)

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2
Q

How does diarrhea cause acidosis?

A

Diarrhea causes loss of HCO3, and Cl is reabsorbed

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3
Q

What happens to Cl levels with intractable emesis? HCO3? K?

A

Cl decreases
HCO3 increases
K decreases

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4
Q

What are the drugs that cause hyperventilation?

A

Beta 2 agonists

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5
Q

What are the primary causes of metabolic alkalosis?

A
  • Vomiting
  • bicab therapy
  • loo and thiazide diuretics
  • Cushings
  • Barter’s syndrome
  • primary aldosteronism
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6
Q

What do the cells exchange in order to balance out acid in serum?

A

K (causes hyperkalemia)

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7
Q

What is the relationship between K levels, and acidosis/ alkalosis?

A 
Alkalosis = hypokalemia
Acidosis = hyperkalemia
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8
Q

What are the three major hormones that cause K to enter the cell?

A

Insulin
Epi
Aldosterone

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9
Q

What is the DOC for hyperkalemia?

A

Insulin + glucose

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10
Q

What is Conn syndrome?

A

Aldosterone producing mass on the adrenal glands

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11
Q

What does aldosterone do to K and H in the body?

A

Increase secretion

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12
Q

Do osmotic diuretics cause K secretion?

A

Yes

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13
Q

What is the effect of acidosis on K secretion?

A

Decreases

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14
Q

How is H secreted in the distal tubules?

A

HPO3

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15
Q

What does ARF usually lead to: acid or alkalosis?

A

Acidosis, with alkaline urine

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16
Q

What is type I RTA?

A

Defect in the distal tubular H secretion

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17
Q

What is type II RTA?

A

Defect in proximal tubular HCO3 absorption

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18
Q

What is type IV RTA?

A

Hypoaldosteronism–hyperkalemia

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19
Q

What type of acidosis occurs with RTAs?

A

Anion gap acidosis

20
Q

What are the common h/o type I RTA?

A

Amp B use

21
Q

What is the defect in fanconi syndrome?

A

Proximal tubule dysfunction, Bicarb reabsorption defect

22
Q

What is the effect of angiotensin on the kidney arteries?

A

Clamps the efferent arteriole

23
Q

What the the protective effect of ACEIs on DM kidneys?

A

Stop hyperfiltration injury

24
Q

Why do all RTAs cause hypokalemia (except type IV)?

A

Cannot get rid of acid, so secrete K

25
Q

What commonly used meds cause type IV RTAs?

A

K sparing diuretics

26
Q

What are the ions that, when increased, replace Na?

A

Li
Ca
Mg
K

Light that Magnificent Californian Pot

27
Q

What is expelled with emesis in terms of ions in the blood?

A

H Cl are lost, HCO3 increases

28
Q

What is the difference between short and long term vomiting on acid/base?

A

Short term no anion gap, but increases gap d/t keto acids with starvation

29
Q

What are the acid/base changes with diarrhea?

A

Decreased HCO3, increased HCl

30
Q

What is the treatment for acute metabolic alkalosos

A

KCl
Acetazolamide
Ammonium chloride

31
Q

What type of acidosis is had with acetazolamide?

A

hyperchloremic

32
Q

What are the MUSHWAR consequences of renal failure?

A
  • Metabolic acidosis
  • Uremia
  • Sodium excess
  • Hyperkalemia
  • Water excess
  • Anemia
  • Renal osteodystrophy
33
Q

What is Winter’s formula? What is it for?

A

Expected pCO2 = (1.5x HCO3) +(8+/-2)

if not within the range, then suspect more than one thing causing acidosis

34
Q

How much should pCO2 drop for every 1 meq drop in HCO3 in metabolic acidosis?

A

0.7

35
Q

pCO2 should increase by about what for every 1 meq increase in HCO3 in metabolic acidosis?

A

0.7

36
Q

What is the expected pCO2 for a metabolic alkalosis?

A

0.7(HCO3) +20 mmHg

37
Q

What is the expected HCO3 for acute respiratory acidosis?

A

24+[(actual PCO2-40)/10]

38
Q

What is the expected HCO3 for chronic respiratory acidosis?

A

24+[(actual PCO2-40)/10]

39
Q

What is the expected HCO3 for acute respiratory alkalosis?

A

24+[(40-actual PCO2)/10]

40
Q

Total CO2 = ?

A

Bicarbonate (NOT pCO2)

41
Q

Acute Loss of volume leads to acidosis or alkalosis? Why?

A

Alkalosis (contraction alkalosis)–bicarb concentration increases

42
Q

Hypovolemia and hypervolemia lead to acidosis / alkalosis?

A

Hypovolemia = alkalosis

Hypervolemia = acidosis

43
Q

How do you differentiate between diarrhea and metabolic causes of hyperchloremic acidosis?

A

Urine anion gap

44
Q

What is the equation for urinary anion gap?

A

Na + K + ***

45
Q

What is the delta / delta ratio?

A

(AG – 12)
___________
(24 - [HCO3¯])

More than 2 means there is more than one acid base disturbance

All the Small Things (29 decks)

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