Acid Base Blitz

Question 1

For every ______ change in HCO3, pH will change _______ in the _______ direction

Answer 1

10mEq/L
0.15mmHg
Same

Bicarb Buddy 15 (same direction 0.15)

Question 2

For every ____ change in PaCO2, pH will change ______ in the _______ direction

Answer 2

10mmHg
0.08mmHg
Opposite direction

Culprit Carbon-8 (opposite 0.08)

Question 3

For every change in pH of _____ K+ will change by ______ in the _______ direction

Answer 3

0.1
0.6
Opposite

Kick Six (opposite 0.16

Question 4

TQ asking you what to treat first when you see acidemia and a high K+

Answer 4

Treat the acidemia first, the underlying cause. Even if they’re saying the ekg has cardiac anomalies… treat the underlying cause

Question 5

Metabolic Acidosis
GOLD MARK

Answer 5

G glycol poisoning (ingestion) ***
O oxyproline (Tylenol ingestion)
L L-lactate (metformin toxicity)
D D-lactate (short bowel syndrome)

M methanol (solvents de-over fluid)
A acetylsalicylic acid **
R renal failure
K ketoacidosis **

*** these will try to (partially) compensate

Question 6

Corrected anion gap calculation

When you have labs and no POC EPOC)

Answer 6

[Na+ - (Cl + HCO3)] + K

(Na+ + K+) - (Cl + HCO3)

> 20 is a metabolic acidosis

Question 7

Alkalosis

Answer 7

Respiratory alkalosis: first stage of shock, PE, high altitude (hypoxia), febrile

Metabolic Alkalosis: Antacid OD, CHF taking diuretics, excess vomiting, NG sxn (stomach acid)
Treat lytes
500mg Acetazolamide for cerebral edema high altitude pulmonary edema, it consumes HCO3

Question 9

Pt has following ABG pH7.1 PaCO2 54 HCO3 24 PaO2 92 etco2 50. Upon arrival to facility etco2 is 30, what would your change in pH reflect?

Answer 9

pH 7.26

10 mmHg change in PaCO₂, pH changes by ~0.08 in the opposite direction