Term
| Kidney response to respiratory alkalosis |
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Definition
| Kidney response kicks in 12-24 hours later. Responds by lowering secretion of H+ and increasing secretion of bicarbonate. |
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Term
| Kidney response to respiratory acidosis |
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Definition
| Kidney response kicks in 12-24 hours later. Responds by lowering secretion of bicarbonate and increasing secretion of H+. |
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Term
| Causes of metabolic acidosis |
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Definition
1. Excess acid production (diabetic ketoacidosis or lactic acid)
2. Renal failure (normal acid production with failure of excretion)
3. Loss of alkali (diarrhea) |
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Term
| Compensation for metabolic acidosis |
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Definition
1. Acute response: hyperventilation creates lowered pCO2, rapid breathing can lower pCO2 to 10-12 mmHg.
pCO2 = 1.5 (HCO3) + 8 (+/-2)
2. Tissues and RBCs increase HCO3 production, take in H+ by exporting Na+ and K+.
3. Extra H+ excreted. |
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Term
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Definition
Cations and anions in body must be balanced.
Major cation=Na+
Major anions=Cl- and HCO3-
When HCO3- level is down, this creates metabolic acidosis.
Normal value of anion gap is 12 +/- 4
In simple acid base disorders, the change in the anion gap is the same as the change in the HCO3- |
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Term
| Types of metabolic acidosis |
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Definition
1. Anion gap metabolic acidosis
2. Non-anion gap metabolic acidosis |
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Term
| Anion Gap metabolic acidosis |
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Definition
When anion gap is over 12 +/- 4
Use AMUDPILES |
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Term
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Definition
1. Aspirin
2. Methanol
3. Uremia (renal failure)
4. Diabetic Ketoacidosis (DKA)
5. Paraldehyde
6. Ischemia/Infarct
7. Lactic Acidosis
8. Ethanol/Ethylene Glycol
9. Sepsis/starvation |
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Term
| Non-anion gap metabolic acidosis |
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Definition
Occurs when anion gap fits within 12 +/- 4 range.
1. Hyperchloremic (increased Cl-) acidosis
2. Hypokalemic
3. Hyperkalemic/normalkalemic |
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Term
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Definition
Look for ingestion of toxic chemicals through changes in plasma osmolarity (measure the number of osmotically active particles).
Standard value: 300 mOsm/L
Measured value:
2xNa + glucose/18 + BUN/2.8
If there is a major difference between the standard osmolar value (300 mOsm/L) and the calculated osmolar value, then the patient probably ingested methanol or ethylene glycol. |
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Term
| Causes of metabolic alkalosis |
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Definition
| 1. Loss of acid through vomiting or hyperaldosterone 2. New HCO3- added through renal or other sources 3. Kidney increases net resorption of HCO3- 4. Volume contraction |
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Term
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Definition
Stimulates H+ secretion and HCO3-synthesis and resorption.
Cause of metabolic alkalemia. |
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Term
| Volume contraction and metabolic alkalemia |
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Definition
Can be done through diuretics and RAAS.
ECF volume contraction increases osmotic forces inside the capillaries which favor resorption of HCO3-. |
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Term
| Types of Respiratory Acidosis |
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Definition
1. Acute (<24 hours)
2. Chronic (>24 hours) |
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Term
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Definition
For every change in pCO2 by 10 mmHg, see 0.08 change in pH
pH=(7.4-.08x)
or
1 mmHg increase in PCO2 → 0.1 mEq increase in HCO3 |
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Term
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Definition
For every change in pCO2 by 10, see 0.03 change in pH
pH=(7.4-.03x)
1 mmHg increase in PCO2 → 0.4 mEq increase in HCO3 |
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Term
| Causes of respiratory acidosis |
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Definition
1. Any pulmonary disease
2. Inhibition of respiratory center: opioid, anesthetics,
3. Disorder of respiratory muscles: Multiple sclerosis, ALS
4. Airway Obstruction |
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Term
| Acute respiratory alkalosis |
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Definition
Renal system does not have time to compensate for changes in pCO2.
For every increase in pCO2 by 10 mmHg, see 0.08 increase in pH
Or
1mEq ↓ PCO2 → 0.2 mEq ↓ in HCO3 |
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Term
| Chronic Respiratory Alkalosis |
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Definition
| For every change in pCO2 by 10, see 0.03 change in pH 1mEq ↓ PCO2 → 0.4 mEq ↓ in HCO3 |
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Term
| Causes of respiratory alkalosis |
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Definition
1. Stimulation of medullary respiration center
2. Hypoxemia
3. Mechanical ventilation |
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