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Respiratory Acidosis
PCO2 >44
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Respiratory Alkalosis
PCO2 <33
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Metabolic Acidosis
Bicard <22
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Metabolic Alkalosis
Bicarb >28
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What acid/base disorder does Thiazide diuretics cause?
- Metabolic Alkalosis - increased bicarb
- blocks Na/Cl transporter in distal tubule but increase Na concentration in tubule which stimulates the aldosterone-sensitive Na pump increasing Na reabsorption in exchange for K& H into the urine and reclaimed bicarb into serum.
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What acid/base disorder does persistent vomiting cause?
- Metabolic Alkalosis, increased bicarb
- -lose acid, increased bicarb in blood excess filtered by kidney
- -volume depletion, decreased peritubular hydrostatic pressure causes renal threshold for bicarb to inrease b/c holding onto Na causes H secretion and brings in more bicarb
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What acid/base disorder does NG tube cause?
- Metabolic alkalosis - increased bicarb
- -loosing acid and volume depleted so holding onto Na at expense of wasting H and thus resorption of bicarb in kidney
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What acid/base disorder does diarrhea cause?
- Non gap Metabolic acidosis (decreased bicarb)
- hyperchloremic: remember for every bicarb lost body holds onto a chloride to balance charges
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What acid/base disorder does amphotericin cause?
- Non Gap Metabolic Acidosis (decreased bicarb)
- Type I Renal tubular acidosis - destroys H/K pump in distal tubule. Cant get rid of H ions
- also loose Calcium due to pump dysfunction
- urine pH >5.5, muscle weakness (hypocalemic)
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What acid/base disorder does aminoglycosides cause?
- Non Gap metabolic acidosis (decreased bicarb)
- type II renal tubular acidosis - destroys proximal tubule
- decreased bicarb threshold in kidney, eventually serum level and threshold stabalize
- urine pH>5.5 (alkaline)
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What acid/base disorder does COPD cause?
Respiratory Acidosis - trouble getting air out...retain CO2
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What acid/base disorder does Guillan Barre cause?
Respiratory Acidosis - depressed respirations due to diaphragm paralysis and retain CO2
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What acid/base disorder does Obstructive sleep apnea cause?
respiratory acidosis - retain CO2
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What acid/base disorder does Cystic fibrosis cause?
- respiratory acidosis
- increased pCO2
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What acid/base disorder does salicylate intoxication cause?
- Respiratory Alkalosis
- over stimulates respiratory center in medulla - low pCO2
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What acid/base disorder does Endotoxins cause?
- from gram neg bacteria infections
- respiratory alkalosis - oversitmulates respiratory center in medulla
- decreased pCO2
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What acid/base disorder does Cirrhosis cause?
- Respiratory Alkalosis
- increased toxins stimulate respiratory center in medulla
- decreased pCO2
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What acid/base disorder does bronchial asthma cause?
- respiratory alkalosis, decreased pCO2
- exception to rule that obstructive lung diseases cause resp acidosis b/c they hyperventilate due to feeling that they can't breath. If they are acidotic intubate b/c it means they are running out of energy to keep breathing
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What acid/base disorder does pulmonary embolus cause?
respiratory alkalosis - tachypnea causes decreased CO2
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What acid/base disorder does sarcoidosis cause?
- respiratory alkalosis, decreased pCO2
- restrictive lung disease...can't get air in ... take small rapid breaths
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What acid/base disorder does CNS injury cause?
respiratory depression ...respiratory acidosis (increased pCO2)
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Causes of increased A-a gradient?
- 1. Ventilation defect - atelectasis (airway collapsed)
- 2. Perfusion defect - Pulmonary embolis
- 3. Diffusion defect - interface altered - fibrosis/ pulmonary fluid. RHF, Pneumonia...
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What acid/base disorder does spirinolactone cause?
- Aldosterone blocker (others include triamterene or amiloride)
- metabolic acidosis
- decreased bicarb <22
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What acid/base disorder does hypoxia cause?
- Hypoxia leads to anaerobic glycolysis and lactic acid formation
- Anion gap metabolic acidosis
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Causes of Anion Gap Metabolic Acidosis?
- M - Methanol
- U - Uremia
- D - Diabetic Ketoacidosis (also alcohol ketosis, starvation ketosis)
- P - Para-aldehyde
- I - Isoniazid, Iron, Inborn Errors of Metabolism
- L - Lactic Acid
- E - Ethylene Glycol
- S - Salicylates
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Calcium oxylate crystals are associated with what acid/base disorder?
- Anion Gap Metabolic Acidosis
- Ethylene Glycol
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What acid/base disorder is associated with smoking?
- Respiratory acidosis
- increased pCO2
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