acid base

Question 1

***normal ph, co2, HCO3, anion gap

Answer 1

pH - 7.4
CO2 - 40
HCO3 - 24
AG - 12

Question 2

what are acid base effects of hypokalemia

Answer 2

• loss of K from cells
• replaced by Na and H
• acidifies cells
• kidney thinks acidy
• makes more HCO3
• results in met alkalosis

Question 3

3 sources of new bicarb

Answer 3

1. vomiting
2. kidney
3. exogenous

Question 4

** 5 steps to solve acid base problem

Answer 4

1. look at pH - acid or alka
2. primary problem (CO2 or HCO3)
3. is there adequate compensation
4. a) anion gap?
   b) osmolar gap
5. is there another metabolic disorder (AG = HCO3)

Question 5

what is compensation for metabolic disorders

Answer 5

acid - HCO3 and CO2 both down 1

alka - HCO3 up 1, CO2 up 0.7

Question 6

compensation for resp

Answer 6

acute acid - CO2 up 10, HCO3 up 1
chronic acid - CO2 up 10, HCO3 up 3
acute alka - CO2 down 10, HCO3 down 2
chornic alka - CO2 down 10, HCO3 down 5

Question 7

what is calc for AG in met acid

Answer 7

Na - (Cl+HCO3)

Question 8

***causes of incr. gap

Answer 8

1. lactic acidosis
2. ketoacidosis
3. toxins
   - salicates
   - methanol
   - ethylene glycol
4. severe Kidney failure

Question 9

causes of normal met acid

Answer 9

NaHCO3 loss

• renal
• GI

Question 10

what is formula for osmolar gap

Answer 10

actual - expected (2[Na] + glucose+ urea)

Question 11

what is osmolar cut-off

Answer 11

if over 10 - alcohol in blood

Question 12

what are numbers for another metabolic process

Answer 12

AG and HCO3 in same amount - none
more HCO3 = AGMA+met alka
less HCO3 = AGMA + NAGMA

Question 13

what is sig. of met acidosis

Answer 13

can help diagonose life threatening illness

- try to keep pH>7