22 Questions
Metabolic acidosis is characterized by:
Decreased bicarbonate and decreased plasma pH.
Which condition causes metabolic acidosis by the kidneys being unable to excrete H+ and produce HCO3?
Diabetic ketoacidosis
What is the primary function of the renal system in regulating acid-base balance?
To conserve and eliminate H+ and HCO3 in response to abnormal pH
What is the normal range of PaCO2?
35-45 mm Hg
What can be a physiological response to metabolic acidosis?
Increased respiration rate.
In metabolic alkalosis, what typically occurs in terms of HCO3 concentration and plasma pH?
Increased HCO3 and increased plasma pH.
What type of acidosis occurs when there is a buildup of carbon dioxide in the blood due to hypoventilation?
Respiratory acidosis
What is the effect of acidosis on the kidneys?
Eliminate H+ and retain HCO3
What is considered a common cause of metabolic alkalosis?
Excessive HCO3 intake.
In metabolic alkalosis, the compensatory response is typically limited in what aspect?
Respiratory rate decreases.
What is the pH range for alkalosis?
pH > 7.45
How does the body compensate for metabolic alkalosis at the respiratory level?
Decreased respiration rate.
What is the response of the kidneys to alkaloid pH?
Eliminate HCO3 and retain H+
What is a common result of hypokalemia?
Tachycardia and confusion.
Which parameter reflects the effectiveness of ventilation in arterial blood gases?
pCO2
What does a PaO2 measurement assess?
Effectiveness of lung oxygenation.
What is the main function of the kidneys in terms of acid-base balance?
To regulate metabolic acid levels
What is the primary function of the lungs in acid-base balance?
To regulate carbon dioxide levels
What condition is characterized by an abnormal increase in the level of carbon dioxide in the blood?
Respiratory Acidosis
What condition is characterized by an abnormal decrease in the level of bicarbonate in the blood?
Metabolic Acidosis
What condition is characterized by an abnormal decrease in the level of carbon dioxide in the blood?
Respiratory Alkalosis
What condition is characterized by an abnormal increase in the level of bicarbonate in the blood?
Metabolic Alkalosis
Study Notes
Acid-Base Imbalance
- pH: 7.35 - 7.45 (normal range)
- Acidosis: pH < 7.35
- Alkalosis: pH > 7.45
Respiratory Acidosis
- Caused by hypoventilation (diminished or inadequate pulmonary ventilation)
- Elevated pCO2 (> 45 mmHg)
- Lungs fail to eliminate CO2, leading to carbonic acid excess
- Kidneys compensate by retaining HCO3 and eliminating excess H+
Metabolic Acidosis
- Caused by:
- Diabetic ketoacidosis
- Renal failure (kidneys unable to excrete H+ and produce HCO3)
- Poisoning (e.g., ASA, recent binge drinking)
- Lost alkali (base) due to severe diarrhea or intestinal malabsorption
- Rhabdomyolysis
- Lactic acidosis
- Decreased HCO3 (< 22 mEq/L)
- Respiratory compensation: hyperventilation (Kussmaul breathing) to blow off CO2
Metabolic Alkalosis
- Caused by:
- Excessive HCO3 intake (e.g., antacids)
- Vomiting or gastric suction
- Loss of acid (e.g., hypovolemia, diuretic use)
- Hypokalemia
- Increased HCO3 (> 26 mEq/L)
- Limited respiratory compensation (decreased respiratory rate)
Renal System Regulation
- Kidneys regulate acid-base balance by eliminating or retaining bicarbonate
- Takes 2-3 days to achieve maximum response, but can maintain indefinitely
- To compensate for acidosis, kidneys generate additional bicarbonate and eliminate excess H+
- To compensate for alkalosis, kidneys eliminate excess HCO3 and retain H+
Partial and Total Compensation
- Partial compensation: pH, CO2, and HCO3 are abnormal, or one value is just starting to change
- Total compensation: pH is normal, but CO2 and HCO3 are abnormal
- Lungs and kidneys work together to correct pH disturbances
Mixed Acid-Base Disorders
- Two or more disorders present at the same time
- pH depends on type, severity, and acuity of each disorder
- Suspect if pH is near normal, but CO2 or HCO3 is abnormal
- Examples: COPD and K+ wasting diuretic, cardiac arrest patient with lactic acid accumulation, patient hyperventilating with post-op pain and acid loss from NG tube
This quiz covers the concepts of metabolic acidosis and alkalosis, including their causes, symptoms, and effects on the body. Topics include pH levels, exchange of ions in cells, and conditions such as diabetic ketoacidosis and renal failure.
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