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inpatient medicine > acid/base > Flashcards

acid/base Flashcards

1
Q

acidemia is a pH less than

A

7.36

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2
Q

alkalemia is a pH greater than

A

7.44

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3
Q

acidosis process that ___H+; alkalosis process that ___H+

A

acidosis increases H+ and alkalosis decreases H+

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4
Q

respiratory compensation by hyper/hypoventilation alters___to counteract a primary metabolic process

A

PaCO2; resp compensation happens in min

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5
Q

renal excretion/retention of ____counteracts a primary respiratory process

A

H+/HCO3; renal compensation takes hours to days

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6
Q

can compensation fully correct pH what if the pH is normal

A

no can never fully correct; if pH is normal or compensation > expected consider mixed disorder

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7
Q

what are some of the consequences of acidemia on the cardiovascular sys

A

pH

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8
Q

consequences of severe alkalemia on CV sys

A

pH >7.6 art vasocon; dec coronary blood flow; inc risk of arrhythmia

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9
Q

consequence of acidemia on resp sys

A

hypervent; dec resp M. strength

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10
Q

consequence of alkalemia on resp sys

A

hypoventilation

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11
Q

metabolic consequences of acidemia

A

inc K, insulin resistance

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12
Q

metabolic consequences of alkalemia

A

dec K, ICa, Mg, PO4

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13
Q

neuro consequences of acidemia

A

change in mental status

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14
Q

neuro consequences of alkalemia

A

AMS, seizure, tetany

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15
Q

what is W/U for an acid/base

A

pH, PaCO2, HCO3- determine if adequate compensation

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16
Q

what is the problem with metabolic acidosis

A

gain of H+ or loss of HCO3; pH, HCO3, PaCO2 all DEC

17
Q

what is the prob c/ metab alkalosis

A

gain of HCO3 or loss of H+; pH, HCO3, PaCO2 all INC

18
Q

what is the problem c/ resp acid

A

hypoventilation: pH DEC; HCO3, PaCO2 both inc

19
Q

what is the prob c/ resp alk

A

hyperventilation: pH INC; HCO3, PaCO2 both dec

20
Q

how do you calc anion gap and what is normal

A

Na- (Cl +HCO3); norm = 12+/-2

21
Q

lungs regulate CO2 via resp rate acidosis stimulates____ & alkalosis _____

A

acidosis stimulates inc resp to blow off excess CO2; alkalosis depress resp to retain CO2

22
Q

kidneys regulate acid/base by

A

generating new HCO3 and eliminating H+; norm resorb all filtered HCO3 @ prox tube

23
Q

what would cause the kidney to resorb more HCO3/bicarb/base

A

inc PCO2(acid), hypovolemia, dec K

24
Q

what is the acronym for AG metab acidosis i.e. too much acid or too little bicarb

A

MUDPILERS: Methanol, Uremia, DKA/ alcoholic keto acid, Propylene glycol, Isoniazid/Infection, Lactic acidosis, Ethylene glycol, Rhabdo/renal fail, Salicylates (ASA)

25
Q

what is the acronym for non gap metab acid

A

HARDUPS: Hyperalimentation, Acetaolamide, Renal tubular acidosis, Diarrhea, Uretero-pelvic shunt, Post-hypocapnia, Spironolactone

26
Q

acronym for acute resp acidosis or anything that dec resp

A

CHAMPP: CNS depress(drugs, CVA), Hemo/pneumothorax, Airway obstruction, Myopathy, Pneumonia, Pulm Edema

27
Q

acronym for metabolic acidosis-little acid or too much bicarb

A

CLEVER PD: Contraction, Licorice, Endo (cushings), Vomit, Excess alk, Refeeding alk, Post hypercapnia, Diuretics

28
Q

acronym for resp alk- anything that causes hyperventilation

A

CHAMPS: CNS dz, Hypoxia, Anxiety, Mech vent, Progesterone, Salicylates/sepsis

29
Q

what happens in anion gap metabolic acidosis

A

acid in the blood dissociates into H+ (buffered by HCO3) and an anion (not measured) accumulates in serum

30
Q

normal anion gap acidosis

A

HCO3- being replaced by CL-

e.g. c/ diarrhea loss of NaHCO3 the kidney tries to preserve vol by retaining NaCl

31
Q

what are some causes of metabolic acidosis

A

loss of H+ from GI/kidney: vomit/NG suction, chronic diarrhea, loop diuretics; exogenous alk, post hypercapnia (mech vent)

32
Q

if PCO2 and pH go in opposite directions

A

primary disorder is resp

33
Q

if PCO2 and pH go in same direction

A

partial resp compensation

34
Q

if HCO3 and pH go in same direction

A

pri metabolic dsrdr

35
Q

if HCO3 and pH go opposite

A

partial metab compensate

inpatient medicine (2 decks)

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