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Clinical Acid-Base
Problems and Treatment
23
Veterinary Medicine
Undergraduate 4
04/12/2014

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Term
Define temperature
Definition
The mean kinetic energy of molecules
Term
Why is does pH change with temperature?
Definition
As temperatures increase past 25 degrees C kinetic energy of the molecules increases. As the enegery increases, the number of molecules that spontaneously ionise increases, causing an increase in the number of H and OH ions present, resulting in a drop in pH
Term
What is the normal measured pH of blood?
Definition
In dogs it is around 7.4
Term
Define dynamic equilrium
Definition
A dynamic equilibrium is a chemical equilibrium between a forward reaction and the reverse reaction where the rate of the reactions are equal.
Term
What is pOH?
Definition
The negative log of [OH]
Term
Give an example of respiratory compensation of acidosis
Definition
An increase in depth and frequency of breath (Hyperventilation)
Term
What is PACO2?
Definition
The concentration of CO2 in the alveoli (note the uppercase 'A')
Term
What is PaCO2?
Definition
The concentration of CO2 in the arteries
(note the lowercase 'a')
Term
What is the difference between acidosis and acidaemia?
Definition
Acidosis - a process that is causing an increase in the H ions
Acidaemia - a net increase of pH that shows a decrease in pH
Term
Is it possible to have acidosis and alkalosis concurrently?
Definition
Yes, as they can be two different processes that are independent of each other
Term
How long does it take renal correction to occur?
Definition
Several days
Term
How long does it take for respiratory compensation to occur?
Definition
It is almost immediate
Term
Will respiratory compensation return the pH to a normal level?
Definition
No, it will not correct the problem, only compensate for it. This is so that the kidneys still know they need to do something about the issue.
Term
Can there be renal COMPENSATION?
Definition
Yes, this happens in cases of chronic respiratory acidosis, but never in acute cases
Term
What is the standardised base deficit?
Definition
THE SBD is measured as the vertical distance between the point that the patient is sitting on the davenport diagram and the buffer line. If the patient is below the buffer line, the number will be positive, if they are above the buffer line then there is an excess of buffer and so the SBD will a negative number.
Term
What points are plotted on the Davenport diagram?
Definition
PaCO2, Bicarb and pH
Term
Which value is shown by curved lines on the Davenport diagram?
Definition
PaCO2
Term
Are there differences in the buffer line between species?
Definition
Yes, this means that the SBD will not be zero for animal patients. The normals for animals follow:
-7 Cats
-2 dogs
+4 horses
Term
Does PaCO2 change with 'herbivouness'?
Definition
Yes,the more plant matter an animal consumes, the higher the PaCO2, this means that horses have a PaCO2 of 46, which cats have one of only 28. This is one of hte reasons behind the species differences in the buffer line
Term
Which cations and anions are measured in a anion gap?
Definition
(Na + K) - (CL + HCO3)
Term
If you have a large anion gap, what does this mean?
Definition
It means that you have an increase in unmeasured anions, usually albumin
Term
What should you do next, diagnostically, if you have a large anion gap?
Definition
Taking history into account, you should measure albumin (or at least TPP) and lactate.
In a horse that has done heavy, exercise, it is expected that lactate will be up and so this does not necessarily need treatment.
Term
Can you use the davenport diagram to determine if the condition is metabolic or respiratory?
Definition
Yes
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