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55 Cards in this Set

  • Front
  • Back
what is a process that tends to lower ECF pH?
what is metabolic acidosis?
low HCO3
what is respiratory acidosis?
high PaCo2
most cases acidosis leads to what?
acidemia (decrease in blood pH)
what is alkalosis?
a process that tends to increase ECF pH
what is high HCO3?
metabolic alkalosis
what is low PaCO2?
respiratory alkalosis
in most cases alkalosis leads to what?
alkalemia (increase in blood pH)
what are characteristics of metabolic acidosis?
-reduced arterial pH (acidemia)
-reduced plasma (HCO3)
what is response to metabolic acidosis?
compensatory hyperventilation and decreased PaCO2
what are some causes of metabolic acidosis?
-inability to excrete dietary H+ load
(renal failure, hypoaldesteronism)
what are some causes of increased H+ load or HCO3 loss?
-lactic acidosis
what is due to severe tissue hypoperfusion assoc w/ shock or cardiopulmonary arrest; seizures?
lactic acidosis
what is cause of HCO3 loss from intestine?
what are pulmonary symptoms of metabolic acidosis?
-marked increase in minute ventilation-compensatory
-dyspnea, hyperpnea
what are cardiac symptoms of metabolic acidosis?
-reduction in ventricular contractility
-potentially fatal ventricular dysrhythmias
what are neurologic symptoms of metabolic acidosis?
symptoms range from lethargy to coma
what is most important buffer response to acidemia?
-extracellular buffering- HCO3 is most important buffer
what are some other buffers for metabolic acidosis?
-intracellular and bone buffering
what is most important respiratory compensation for metabolic acidosis?
-stimulation of peripheral and central chemoreceptors-increase in alveolar ventilation
the increase in ventilation does what to try and compensate for metabolic acidosis?
-decrease CO2 and allows CO2/HCO3 system to shift to the left
on avg PaCO2 will fall how much for every 1.0meq/L in the plasma HCO3?
1.2 mmHg
PaCO2= ?
(HCO3 x 1.5) + 8
last two digits of the pH=?
HCO3 + 15
PaCO2 substantially different from predicted suggests what?
a mixed acid-base disturbance
what is renal compensation responsible for?
-ultimately responsible for excreting excess H+ in order to correct ECF pH; requires several days
what is principal compensatory response from renal system?
increased tubular cell NH3 production and excretion of H+ as NH4--can exceed 250meq per day
what are characteristics of respiratory acidosis?
-reduced arterial pH (acidemia)
-elevation in PaCO2 (hypercapnia)
-variable increase in plasma HCO3
becaue the CO2 stimulus to ventilation is so strong hypercapnia and resp acidosis are almost always due to what?
a reduction in effective alveolar ventilation
what are neurologic symptoms of acute hypercapnia?
-blurred vision
what are cardiovascular symptoms of acute hypercapnia?
-peripheral vasodilation
is the CO2/HCO3 buffer a good buffer in the acute rsponse to resp acidosis?
not an effective buffer in this situation
what are some important intracellular buffers?
Hgb and other protein important in buffering H+
on avg there will be how much of rise in plasma HCO3 for every 10mmHG rise in PaCo2?
1 meq/L
persistent elevation of PaCO2 stimulates renal H+ secretion resulting in what?
addition of HCO3 to the ECF
after several days of acidosis a new steady-state is reached in which there is how many meq/L increase in plasma HCO3 for every how many mmHg rise in PaCo2?
4 meq/L for every 10mmHg rise in PaCO2
the extent of the increase in plasma HCO3 in chronic respiratory acidosis is determined by what?
the extent to which renal H+ secretion increases
what are characteristics of metabolic alkalosis?
-elevation in arterial pH (alkalemia)
-increase in plasma HCO3
-compensatory hypoventilation resulting in a rise in PaCO2
a rise in plasma HCO3 ususally results from what?
H+ loss from the GI tract or in teh urine
what are symptoms of metabolic alkalosis?
-muscle cramps
-postural hypotension
-hypokalemia (muscle weakness)
development of alkalemai is sensed by what?
the peripheral chemoreceptors, resulting in a decline in ventilation and an appropriate increase in PaCO2
an avg PaCO2 increases how much for every 1.0 meq/L increase in plasma HCO3?
0.6 mmHg
usually metabolic alkalosis is self limiting b/c why?
kidneys excrete increase HCO3
perpetuation of metabolic alkalosis requires what?
some impairment in renal HCO3 excretion due to increased tubular HCO3
what are some characteristics of respiratory alkalosis?
-elevated arterial pH (alkalemia)
-elevated PaCO2 (hypocapnia)
-variable reduction in plasma HCO3
what are neurologic symptoms of resp. alkalosis?
-altered consciousness
(related to increased membrane excitability and impaired cerebral function)
there is a reduction in cerebral blood flow by how much w/ resp alkalosis?
what are cardiac symptoms of resp alkalosis?
what is another symptoms of resp alkalosis?
what is an acute response to respiratory alkalosis?
H+ move frm cells into the ECF, combine w/ HCO3 and cause an appropriate fall in plasma HCO3
w/ resp alkalosis an avg plasma HCO3 is reduced by how much for each 10mmHg decrease in PaCO2?
2 meq/L
what is a chronic response to persistent hypocapnia in resp alkalosis?
-compensatory decrease in renal H+ secretion
-increased urinary excretion of HCO3 and decreased NH4 excretion (lower plasma HCO3)
when a steady state in resp alkalosis is reached how much is the plasma HCO3 reduced?
by 5meq/L for each 10 mmHg decrease in PaCO2
causes of metabolic acidosis- MUDPILES?
D=Diabetic ketoacidosis
P=paraldehyde, propylene glycol
I=infection, iron;ionized (INH)
L=Lactic acidosis
E= Ethylene Glycol r ethanol ing.
S= salicylates
causes metabolic acidosis w/ nml anion gap= HARD UP?
H=hyperalimentation (w/ TPN)
R=RTA (renal tubule acidosis)
P=pancreatic fistula