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27 Cards in this Set
- Front
- Back
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What are causes of respiratory acidosis?
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• primary pulmonary disease
• neuro-muscular disease • primary CNS dysfunction • drug-induced hypoventilation * all disorders that reduce pulmonary function & CO2 clearance |
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What are the most common clinical characteristics of respiratory acidosis?
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• headache
• drowsiness |
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How do the kidneys compensate for respiratory acidosis?
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• after 2-5 days, kidneys will increase H+ secretion
• increase HCO3 production |
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What are causes of respiratory alkalosis?
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• hyperventilation (most common)
• gram-negative septicemia • hypoxia • liver insufficiency • pregnancy • primary CNS dysfunction • salicylate intoxication |
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What are clinical features of respiratory alkalosis?
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• acroparesthesias
• circuoral paresthesias • giddiness • light-headedness • varied breathing pattern (frequent, deep, sighing to sustained, rapid, deep breathing) |
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How do the kidneys compensate for respiratory alkalosis?
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• decrease H+ secretion (holds on to H+)
• decrease in HCO3 • increase of Chloride level |
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What are causes of metabolic acidosis?
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• Diabetic ketoacidosis
• Ethylene glycol ingestion • Lactic acidosis • Salicylate intoxication • Starvation ketosis |
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What are causes of H+ retention (which can cause metabolic acidosis)?
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• adrenal insufficiency
• renal insufficiency • renal tubular acidosis |
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What are causes of HCO3 loss and have a normal anion gap?
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• diarrhea
• pancreatic or biliary drainage • ureterosigmoidostomy |
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What are clinical features of metabolic acidosis?
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• hyperventilation (earliest sign)
• ventricular arrhythmias • neurologic symptoms (lethargy to coma) |
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What are causes of metabolic alkalosis (at the ion level)?
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• loss of H+
• addition of HCO3 • disproportionate loss of chloride |
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What are clinical features of metabolic alkalosis?
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• neurologic symptoms
• volume depletion symptoms • symptoms of K+ loss |
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Give examples of neurologic symptoms seen in metabolic alkalosis
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• carpopedal spasm
• confusion » stupor » coma • light-headedness • paresthesia |
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Give examples of volume depletion symptoms seen in metabolic alkalosis
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• muscle cramps
• postural dizziness • weakness |
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Give examples of symptoms seen in metabolic alkalosis due to potassium loss
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• muscle weakness
• polyuria • polydipsia |
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What is the treatment for metabolic alkalosis?
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• IV Normal Saline for vomiting & diuretic induced
• replace K+ |
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What is a potential complication of giving too much fluid in diuretic-induced metabolic alkalosis?
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CHF
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What is the definition of anion gap?
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difference between calculated serum anions and cations
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How do you calculate anion gap?
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Serum sodium - serum chloride - serum bicarbonate
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What are causes of a low anion gap?
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• Hyponatremia
• Hypermagnesemia • Hypoalbuminemia • paraproteinemia (Multiple Myeloma) • Spurious hyperchloremia (Bromide toxicity) |
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What are causes of a high anion gap?
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Pneumonic: MUDPILES
• M - Methanol • U - Uremia • D - Diabetic ketacidosis • P - Paraldehyde • I - Iron, isoniazid (INH) • L - Lactic Acid • E - Ethanol, ethylene glycol • S - Salicylates |
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What is the normal compensatory change in metabolic acidosis?
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PaCo2 decrease 1.2 mmHg per 1mEq/L bicarbonate fall
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What is the normal compensatory change in metabolic alkalosis?
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PaCO2 increases 6 mmHg per 10 mEq/L bicarbonate rise
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What is the normal compensatory change in acute respiratory acidosis?
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HCO3 increases 1 meq/L per 10 mmHg PaCO2 rise
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What is the normal compensatory response in chronic respiratory acidosis?
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HCO3 increases 4 meq/L per 10 mmHg rise
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What is the normal compensatory response in acute respiratory alkalosis?
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HCO3 decreases 2 meq/L per 10 mmHg PaCO2 fall
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What is the normal compensatory response in chronic respiratory alkalosis?
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HCO3 decreases 4 mEq/L per 100 mgHg PaCO2 fall
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