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53 Cards in this Set

  • Front
  • Back
What is the normal arterial blood pH?
7.35-7.45
Arterial pH of less than 7.35 is the definition of?
acidosis
Arterial blood greater than 7.45 is the definition of?
alkalosis
Only a single acid base process and it's expected compensation are present is the definition of?
simple disturbance
Two or more primary acid base disturbances are present is the definition of?
mixed disturbances
When you are presented with mixed disturbances, what will the arterial pH depend on?
the direction and magnitude of the disturbance
The physiologic metabolic and respiratory changes to return the pH toward normal in response to a primary acidosis or alkalosis is the definition of?
compensation
True or False: normal pH = absence of acid base problems
False
normal pH does not mean no acid base problems
When is compensation total or complete?
when pH is corrected to normal
What are the critical values of arterial blood pH?
<7.2
>7.6
What is the normal range for PaCO2?
35-45 mmHg
This value reflects the effectiveness of lung function and the body's ability to get rid of carbon dioxide
PaCO2
What is the normal values for PaO2?
80-100 mmHg
What is the critical value for PaO2?
< 60 mmHg
This indicates the amount of oxygen presented to the tissues?
PaO2
What is the normal range of bicarb?
24-30 meq/L
This reflects how well the kidney works
Bicarb
Low bicarb and low pH indicates what type of disorder?
metabolic acidosis
What is the compensatory response to metabolic acidosis?
decrease pCO2
Increase pH and increase bicarb indicates what type of disorder?
metabolic alkalosis
What is the compensatory response to metabolic alkalosis?
increase pCO2
Low pH and low pCO2 indicates what type of disorder?
Respiratory acidosis
What is the compensatory response to respiratory acidosis?
increase bicarb
High pH and low pCO2 indicates what type of disorder?
Respiratory alkalosis
What is the compensatory response to respiratory alkalosis?
decrease bicarb
What is the normal value for the anion gap?
10 + or - 2 mmol/L
What anions are used to measure the anion gap?
Na, Cl, bicarb
What are the unmeasured anions?
albumin, phosphates, sulfates, organic anions
True or False: diabetic ketoacidosis can cause a high anion gap
True
What does a high anion gap indicate?
metabolic acidosis
True or False: alcoholic ketolactic is not a cause of high anion gap
False
alcoholic ketolactic acid can cause high anion gap
What are the toxins that can cause high anion gap?
methanol, ethylene glycol, salicylate, paraldehyde
True or False: only lactic acidosis can cause high anion gap
False:
diabetic ketoacidosis, alcoholic ketoacidosis, lactic acidosis, renal failure and toxins can all cause high anion gap
True or False: Hyperchloremia with a normal anion gap value indicates metabolic acidosis
True
What can cause lactic acidosis?
increased tissue lactate production
decreased lactate utilization
What can cause an increase tissue lactate production?
congenital defects
tissue hypoxia
enhanced metabolic rate
What can cause decreased lactate utilization?
hypoperfusion
liver disease
ethanol intoxification
What are the major causes of hyperchloremic metabolic acidosis?
GI bicarb loss
Acid gain
What can cause GI bicarb loss?
diarrhea, pancreatic drainage, ureteral diversion
What can cause acid gain?
hyperalimentation fluids, ammonium chloride ingestion
hyperventilation is a sign/symptom of what acid-base imbalance?
metabolic acidosis
Patient has pH=7.31, pO2 = 95 mmHg, pCO2 = 37 mmHg, bicarb = 15 mmHg

Labs show: Na 135, K 3.8, Cl 105, BUN 30, creat 1.8

What is a likely disorder that the patient may have?
metabolic acidosis

low pH, low bicarb indicates metabolic acidosis
How do you treat metabolic acidosis?
giving bicarb or citrate/acetate solutions
What is type of compensation is faster, lungs or kidney?
lungs
What are the causes of respiratory acidosis?
impaired alveolar gas exchange
COPD
disorders of respiratory muscles
inhibition of brain respiratory center
What does the patient likely have:
pH 7.38, pCO2 50, pO2 50, bicarb 30
respiratory acidosis

normal pH, but high pCO2 and high bicarb indicates respiratory acidosis
What is metabolic acidosis almost always secondary to?
volume contration
What does the patient likely have:
pH 7.38, pCO2 50, pO2 50, bicarb 30
respiratory acidosis

normal pH, but high pCO2 and high bicarb indicates respiratory acidosis
True or False: in patients with metabolic alkalosis, increase in bicarb is related to abnormal renal bicarb absorption
True
How do you treat metabolic alkalosis?
fluid replacement
acetazolamide
HCL
ammonium chloride
Is HCl the first line of treatment for metabolic alkalosis?
no, it is used in the worst case scenario
What are the causes of respiratory alkalosis?
hypoxemia
pulmonary disease
stimulation of respiratory center in brain
over-ventilation
How do you treat respiratory alkalosis?
treat underlying disorder