Term
| The body regulates acids and bases through four buffer systems. Name them: |
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Definition
1.Bicarb
2. Phosphate
3. Hemoglobin
4. Proteins |
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Term
| What are the four organs with buffering mechanisms? |
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Definition
- lungs (min-hrs)
- Ionic shift (intracellular exchange of K and Na for H (2-4 hrs)
- Kidneys (bicarb resorb, ammonia/phosphate excretion) hrs-days
- Bone (exchange Ca/P and release of carbonate) Hrs-days |
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Term
| If we know what ONE buffer system is doing ... ? |
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Definition
| We know what they are all doing, because they are all in equilibrium. |
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Term
| What are the common causes of metabolic alkalosis (contraction alkalosis)? |
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Definition
- Prolonged Vomiting
- Gastric suctioning
- Tums
- Diuretic treatment |
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Term
| What are the causes of Respiratory Acidosis (aka hypercapnia--too much CO2)? |
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Definition
- Depression of the respiratory center (DRUGS! Brainstem trauma!)
- Pulmonary edema (any kind of impaired gas exchange on the alveolar level) |
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Term
| What are the causes of Respiratory Alkalosis (hypocapnia/not enough O2)? |
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Definition
| - HYPOXIA, hyperventilation or pulmonary disease caused by HEART FAILURE, HIGH ALTITUDE or hypermetabolic states like fever, anemia or improper use of mechanical ventilators. |
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Term
| What is the formula converting mg/dL into mmol/L? How do you convert that into mEqu? |
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Definition
(mg/dL x 10)/MW
x valence = mEq/L
x n = mmol/Kg |
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Term
| How does the body convert CO2 to HCO3- ? (give chemical equation) |
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Definition
CO2+H2O --> H2CO3 ---> H+ + HCO3-
Lungs Hg Kidneys |
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Term
| Vomiting causes what A/B imbalance? |
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Definition
| Metabolic alkalosis (loss of Na, K, Cl and K+) |
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Term
| Diarrhea causes what A/B imbalance? |
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Definition
| Metabolic Acidosis from loss of bicarbonate in poo. |
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Term
| What is the ion shift when serum is Alkalotic? |
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Definition
| H+ shifts OUT of cells and K+ shifts INTO cells resulting in LOWER Serum K |
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Term
| What is the ion shift when serum is Acidotic? |
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Definition
| H+ shifts INTO cells and K+ shifts out of cells creating higher Serum K levels. |
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Term
| What does the Anion gap tell you? |
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Definition
| Helps to differentiate between different types of metabolic acidosis. It tells you if there is an excess of unmeasured serum ANIONS or not enough CATIONS |
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Term
| What is measured in the anion gap? How do you calculate it? |
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Definition
Mainly ALBUMIN
Na - (Cl + HCO3)
OR
(Na+K) - (Cl+HCO3) |
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Term
| What is HYPERCHLOREMIC METABOLIC ACIDOSIS? |
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Definition
| When you have metabolic acidosis with a normal Anion Gap of 3-11 mEq/L because the bicarbonate loss is compensated with Cl retention. |
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Term
| What are some unmeasured Anions that can be detected by the anion gap? |
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Definition
Sulfate
Lactate
Phosphate
Albumin
Ketoacids |
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Term
| What are some causes of NORMAL acidosis with HYPOCHLOREMIC Metabolic Acidosis? |
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Definition
- Loss of Bicarb through GI, Renal dyfxn (Type 2 renal tubular acidosis)
- Ingestion of Cl
- Ketoacidosis |
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Term
| What are some causes of a HIGH anion gap and Metabolic acidosis? |
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Definition
- Lactic acidosis (LACTATE!)
- Ketoacidosis
- Renal Failure (sulfate, PO4)
- Ingestions (Antifreeze/Ethylene Glycol)
- Massive Rhabdomyolysis |
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Term
| What is Contraction Alkalosis? How can you resolve Contraction Acidosis? |
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Definition
A FORM OF METABOLIC ALKALOSIS
ECF Deficit
Acid Deficit
K Deficit
ONLY WAY TO RESOLVE IS REPLACE THE ECF AND K!!! |
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