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Glossary of acid base pathology

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What is the primary disturbance in Metabolic acidosis?
a decrease in bicarbonate
What is the compensation?
increased excretion of bicarb by the kidney
What are common causes?
diabetic ketoacidosis (production of ketone acids), diarrhea (loss of GI bicarb), salisylate overdose, acetazoleamide (diuretic) OD, lactic acidosis, renal failure (can't excrete organic acids), ethylene glycol ingestion
What is the primary disturbance in respiratory acidosis?
A build-up in CO2
What are some common causes?
hyperventilation, high altitude, pneumonia and pulmonary embolus (hypoxemia causes hyperventilation_
What is the primary disturbance in metabolic alkalosis?
increased bicarbonate
What is the primary disturbance in respiratory alkalosis?
A drop in CO2
What is the Henderson Haselbach equation?
pH = pKa + Log (HCO3-)/(.03*pCO2)
Is there an awesome graph on page 277 that you should know?
Yes
Low pH, low pCO2 (low HCO3-)
metabolic acidosis
Low pH, high pCO2 (high HCO3-)
chronic respiratory acidosis
High pH, low pC02 (low HC03-)
acute respiratory alkalosis
High pH, high pCO2 (high HCO3-)
metabolic alkalosis
pH < 7.4
acidosis
pH > 7.4
alkalosis
Within acidosis: P (CO2) > 40
Respiratory acidosis
Within acidosis: Hypoventilation or Hyperventilation
HYPO
Within acidosis: Causes
chronic lung disease, Acute lung disesae; Drugs (opioids, narcotics, sedatives); Weakening of Resp. muscles
Within acidosis: P (CO2) < 40
Metabolic acidosis with compensation
Within acidosis: What should you do next?
Check Anion Gap
Within acidosis: What is the normal anion gap?
8-12 mEq/L
Within acidosis: Increased Anion Gap - 4 Causes
Renal Failure; Lactic acidosis; Ketoacidosis; Aspirin ingestion
Within acidosis: Normal anion gap (4)
Diarrhea; Sniffin' Glue; Renal Tubular acidosis; Hyperchloremia
pH > 7.4 pH > 7.4
alkalosis
pH > 7.4 pCO2 < 40
Respiratory alkalosis
pH > 7.4 Causes (2)
HYPERventilation; aspirin ingestion (early)
pH > 7.4 pCO2 > 40
metabolic alkalosis w/ compensation
pH > 7.4 Causes (4)
vomiting; diuretic use; antacid use; hyperALDOsteronism
Anion gap acidosis: How do you calculate it
Na - Cl - HCO3
Anion gap acidosis: What is normal?
8-12 mEq/L
Anion gap acidosis: What is the mnemonic
MUD PILES
Anion gap acidosis: M
Methanol
Anion gap acidosis: U
Uremia
Anion gap acidosis: D
DKA
Anion gap acidosis: P
Paraldehyde or Phenformin
Anion gap acidosis: I
Iron tablets or INH
Anion gap acidosis: L
Lactic Acidosis
Anion gap acidosis: E
Ethanol, Ethylene Glycol
Anion gap acidosis: S
Salicylates
Acid Base Compensations: Metabolic acidosis
pCO2 = 1.5(HCO3) + 8 +/- 2
Acid Base Compensations: Metabolic alkalosis
pCO2 increases 0.7 mm Hg per 1 mEq/L HCO3 increase
Acid Base Compensations: Respiratory acidosis (acute)
HCO3 increases by 1 mEq/L for every 10 mmHg increase of pCO2
Acid Base Compensations: Respiratory acidosis (chronic)
HCO3 increases by 3.5 mEq/L for every 10 mmHg increase of pCO2
Acid Base Compensations: Respiratory alkalosis (acute)
HCO3 decreases by 2 mEq/L for every 10 mmHg decrease of pCO2
Acid Base Compensations: Respiratory alkalosis (chronic)
HCO3 decreases by 5 mEq/L for every 10 mmHg decrease of pCO2

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