TBL Kidney-Cremo

Question 1

What are some common clinical causes of respiratory acidosis?

Answer 1

-CNS depression
(drug overdose or anesthesia)
-Severe asthma attack
-COPD
-Severe pneumonia
-Upper airway obstruction
-Severe pulmonary edema
(anything that you cant breath out)

Question 2

What are some common clinical causes of respiratory alkalosis?

Answer 2

-Voluntary hyperventilation
-Hypoxemia
-Liver failure
-Anxiety hyperventilation system
-Sepsis
-Any acute pulmonary problem
(acute pulmonary embolism, pneumonia, mild asthma attack, mild pulmonary edema)
(breathing out too much!)

Question 3

IN A CLOSED SYSTEM

If you add a strong acid to your blood what happens to PaCo2? What happens to your bicarb?

Answer 3

PaCo2 will go unchanged but bicarb will go down

Question 4

IN A CLOSED SYSTEM
If you add a strong base to your blood what happens to PaCO2?
What happens to your bicarb?

Answer 4

You PaCO2 will go unchanged but bicarb will go up!

Question 5

What is another name for metabolic acidosis?

Answer 5

hypobicarbonatemia

Question 6

What is hypobicarbonatemia and what causes it?

Answer 6

an increase in EAP

• derangements in gut function
• derangements in metabolism
• due to exogenous intoxicants
• reduced net acid excretion due to renal defects

Question 7

What does diarrhea cause and why?

Answer 7

metabolic acidosis

secrete bicarb in stool and get blood reabsorption of H

Question 8

What are the causes of metabolic acidosis?

Answer 8

• Diarrhea or laxative
• imbalance between organic acid production and consumption
• hypoxia
• lactic acidosis (strenuous exercise with volume depletion)
• ketoacidosis (diabetes)
• methanol and ethylene glycol (alcohol)

Question 9

What are the causes of gap metabolic acidosis?

Answer 9

1. Ketoacidosis (acetoacetate, B-hydroxybutyrate)
2. Lactic acidosis
3. Renal failure (sulfate, urea, phosphate, hippurate)
4. Methanol (formate)
5. Ethylene glycol

Question 10

What causes metabolic alkalosis?

Answer 10

-vomiting or nasogastric drainage

Question 11

What 2 things does metabolic alkalosis require?

Answer 11

both a generation mechanism (vomiting) and a maintenance mechanism

Question 12

what are the three maintence mechanisms for metabolic alkalosis?

Answer 12

volume depletion
hypokalemia
aldosterone excess

Question 13

How do you check for acute respiratory acidosis compensation?
For respiratory alkalosis compensation?

Answer 13

for every 10 mm Hg increase in CO2 there is a .07 decrease in pH
For every 10mm Hg decrease in CO2 there is a .08 increase in pH

Question 14

How does HCO3 look in acute respiratory acidosis?

In acute respiratory alkalosis?

Answer 14

increase by 1mM

decrease by 2mM

Question 15

how long does it take for equilibration of body buffers after respiratory acidosis?
how long does it take for the kidney to compenste?

Answer 15

10 min

4 days

Question 16

Whats a quick and dirty way to predict metabolic alkalosis compensation?

Answer 16

PaCO2 up by .5-1 mm Hg for each 1 mM rise in [HCO3-]