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14 Cards in this Set

  • Front
  • Back
How do the kidneys maintain the bicarbonate buffer system?
1.) reabsorption of HC03 in proximal tubles + distal tubules

2.) Generation of new bicarbonate: via proton secretion
Stimuli for proton secretion?
Acidosis + aldosterone secretion
Stimuli for bicarbonate reabsorption?
Hypercapnia, extracellular fluid contraction, and potassium depletion
What are metabolic distrubances?
Changes in concentration of bicarbonate
What are respiratory disturbances?
Changes in C02 concentration
What are some causes of metabolic acidosis?
1.) increased nonvolatile acid production
2.) decreased acid excretion from kidneys
3.) loss of alkalai (diarrhea)
Define the equation for measuring anion gap:
What causes anion gap acidosis?
ONLY increaed production of nonvolatile acids. These acids are buffered by HC03, and in the process reduced HC03 concentration and lead to increased anion gap acidosis.

Normal 8-12 meq/L
Causes of metabolic alkalosis?
increased loss of acid (kidney/GI excretion)
What is the differential diagnosis for metabolic acidosis with increased anion gap?
1.) Lactic acidosis (hypoxia, hepatic faliure)
2.) ketoacidosis (type 2 diabetes, starvation, alcoholism)
3.) salicyclates, methanol, ethylene glycol
4.) renal faliure
What is the differential diagnosis for metabolic acidosis with normal anion gap (8-12)?
1.) renal tubular acidosis, K+ sparing diuretics, hypoaldosteronism
2.) loss of base (diarrhea, CA inhibitors, pancreatic fistula, ureterosigmoidoscopy)
3.) Excess acid intake (ammonium chloride)
What is the differential for metabolic alkalosis?
1.) Volume loss (vomiting, gastric drainage, diuretics, villous adenoma)
2.) Hypermineralocorticoid syndrome (cushings, exogenous steroids, 1 aldosternoism)
3.) Potassium deficiency
4.) Excess alkali intake (milk-alkali syndrome)
What is the differential for respiratory acidosis?
Basically, the following are the causes of decrease in ventilation:

1.) Drug intoxication or cardiopulmonary arrest
2.) Respiratory faliure (obesity, COPD, neurmoscular disorders...guillan-barre)
What is the differential for respiratory alkalosis?
Following are the casues of hyperventilation:

1.) hypoxia (asthma, pulmomary edema, pulmonary fibrosis, high altitude)

2.) increased respiratory drive (anxiety, salicylate intoxication, cerebral disease, fever)
3.) cirrhosis
4.) excessive mechanical ventilation