Acid Base

Front 1

How do you calculate anion gap?

Back 1

Na - (bicarb + chloride)

Front 2

How do you calculate urine anion gap?

Back 2

(UNA + UK) - Ucl

Front 3

What is the normal value of pH?

Back 3

7.35-7.45

Front 4

How much acid per day must be excreted in the urine?

Back 4

70mmole H+/day

Front 5

Which buffer is the predominate ECF buffer?

Back 5

bicarbonate/carbonic acid buffer

Front 6

pH is proportional to the ratio of what?

Back 6

HCO3/PCO2

Front 7

What is normal HCO3?

Back 7

24

Front 8

What is normal PCO2?

Back 8

40

Front 9

What is the normal base/acid ratio?

Back 9

20:01

Front 10

Increased CO2 in the blood stimulates central and peripheral chemoreceptors to do what?

Back 10

Increase respiration

Front 11

What are threee general causes of metablic acidosis?

Back 11

increased H+ produced; Decreased H+ excreted; Loss of bicarbonate (renal or GI)

Front 12

Is diarhea a normal-gap or anion gap metabolic acidosis?

Back 12

Normal Gap

Front 13

In metabolic causes, arrows point in the (same or opposite)?

Back 13

SAME

Front 14

What is the next steo after determining the presence of metabolic acidosis?

Back 14

appropriate or inapropriate respiratory compensation (1.5 x Bicarb + 8)

Front 15

After determining proper compensation in metabolic syndromes, what is the next step?

Back 15

Anion Gap?

Front 16

What is a normal anion gap?

Back 16

12 (9 - 15)

Front 17

What is most of the anion gap due to ?

Back 17

albumin

Front 18

Elevations above normal anion gap is caused by excess?

Back 18

ACID

Front 19

What is the mnemonic for the differential of elevated anion gap metabolic acidosis?

Back 19

MUDPILES (methanol, uremia, diabetic ketoacidosis, paraldehyde, iron/isoniazid, lactic acidosis, ethylene glycol, salicylates)

Front 20

What is another term for normal anion gap acidosis?

Back 20

hyperchloremic anion gap acidosis

Front 21

What are the general reasons for normal anion gap acidosis?

Back 21

Excessive loss of bicarbonate from the body (diarrhea, or renal tubular acidosis)

Front 22

What happens to the anion gap normal when hypoalbuminemia is present?

Back 22

Decreases (2.5 per 1)

Front 23

Renal tubular acidosis leads to (anion gap, normal anion gap) acidosis?

Back 23

Normal anion gap acidosis

Front 24

What is an important clue of distal renal tubular acidosis?

Back 24

inappropriatly acidified urine (pH > 5.3)

Front 25

Which renal tubular acidosis is associated with hypoaldosteronism, diabetes, and renal insufficiency.

Back 25

Hyperkalemic distal

Front 26

What lab test can indicate normal anion gap metabolic acidosis due to renal tubular acidosis?

Back 26

urine ammonium OR positive urine anion gap (should be negative in acidosis)

Front 27

Both diabetes mellitus and RTA present with polyuria and metabolic acidosis, how are they distinguished?

Back 27

Anion Gap (elevated in DM)

Front 28

Impaired respiratory function will lead to respiratory (alkalosis, acidosis)?

Back 28

Acidosis

Front 29

What are some drugs that can cause a respiratory acidosis?

Back 29

opiate/heroin

Front 30

What kind of acid/base abnormality will muscle weakness, extreme obesity, and chest cage abnormalities cause?

Back 30

respiratory acidosis

Front 31

In respiratory causes arrows are (same or opposite)?

Back 31

Opposite

Front 32

When does metanolic compensation occur in acute and chronic?

Back 32

acute = mins - hours; chronic = 3-5 days

Front 33

What calculation is used for respiratory acidosis and compensatory metabolic alkolosis?

Back 33

increase 1 for every 10 PCO2 (ACUTE); 3.5 for every 10 (Chronic)

Front 34

What calculation is used for respiratory alkalosis and compensatory metabolic acidosis?

Back 34

decrease 2 for every 10 (acute); 5 for every 10 (chronic)

Front 35

What calculation is used for metabolic alkalosis and compensatory respiratory acidosis?

Back 35

increase 6 for every 10 (HCO3)

Front 36

What are the general mechanisms for metabolic alkalosis?

Back 36

urinary or GI loss of Hydrogen (vomiting, diuretics) OR gain of alkali (mineralcorticoid excess - cushings)

Front 37

What are some clinical signs associated with chloride responsive metabolic alkalosis?

Back 37

volume depletion and low urine chloride

Front 38

What can exogenous administration of bicarboate and mineralcorticoid excess lead to?

Back 38

chloride unresponsive metabolic alkalosis

Front 39

Cushings can lead to ?

Back 39

non chloride responsive metabolic alkalosis (mineralcorticoid excess)

Front 40

diarrhea can lead to ?

Back 40

Normal anion gap acidosis

Front 41

vominting can lead to

Back 41

chloride responsive metabolic alkalosis

Front 42

Pulmonary emboli can lead to ?

Back 42

respiratory alkalosis (due to hypoxemia stimulating respiration)

Front 43

pneumonia can lead to

Back 43

respiratory alkalosis

Front 44

COPD can lead to

Back 44

respiratory acidosis (decreased lung ventilation)

Front 45

What are the two additional things that can be present in an elevated anion gap metabolic acidosis?

Back 45

metabolic alkalosis AND non-anion gap metabolic acidosis (USE delta-delta)

Front 46

If the change in anion gap is greater than the change in bicarbonate, what is the other disorder?

Back 46

metabolic alkalosis

Front 47

If the change in anion gap is less than the change in bicarbonate., what is the other disorder?

Back 47

non-AG metabolic acidosis (diarrhea)

Front 48

How can you calculate delta-delta?

Back 48

take AG, subtract the normal = dAG; IF normal your HCO3 should be 24 - dAG. If its higher then metabolic alkalosis, if its lower than NAGMA.