PT 5 - Acid-Base Disorders - 2018

This lecture covers acid-base disorders for the PT 5 course.

Introduction & Background

Introduction & Background

Question #1

Which of following acid-base pairs is the most physiologically important?

  • Carbonic Acid - Bicarbonate
  • Monobasic - Dibasic Phosphate
  • Ammonium - Ammonia
  • Lactic Acid - Lactate

Primary Acid-Base Disorder Analysis

Primary Acid-Base Disorder Analysis

Question #1

  • Acidosis
  • Alkalosis
  • Neither

Question #1 Review

Evaluating Acid-Base Disorders

Evaluating Acid-Base Disorders

Question #2

  • Respiratory Acidosis
  • Metabolic Acidosis
  • Metabolic Alkalosis
  • Respiratory Alkalosis

Question #2 Review

Question #3

  • Respiratory Acidosis with expected compensation
  • Respiratory Acidosis with Unexpected compensation

Question #3 Review

Question #4

The anion gap is: 

The albumin corrected anion gap (ACAG) is: 

Question #4 Review

Question #5-a

  • Yes, the Delta ratio should be calculated
  • No, the Delta ratio should NOT be caluclated

Question #5-b

  • Yes, the urinary anion gap should be calculated
  • No, the urinary anion gap should NOT be calculated

Question #5 Review

Metabolic Acidosis

Metabolic Acidosis

Metabolic Alkalosis

Metabolic Alkalosis

Respiratory Acidosis

Respiratory Acidosis

Respiratory Alkalosis

Respiratory Alkalosis

Practice Case 2

Question #6

  • Acidosis
  • Alkalosis
  • Neither

Question #7

  • Respiratory Alkalosis
  • Metabolic Alkalosis
  • Respiratory Acidosis
  • Metabolic Acidosis

Question #8

  • Metabolic Alkalosis with expected compensation
  • Metabolic Alkalosis with UNexpected compensation
  • Respiratory Alkalosis with expected compensation
  • Respiratory Alkalosis with UNexpected compensation

Question #9

Note: Due to the primary acid-base disorder being an alkalosis, the anion gap would often NOT be calculated. Remember the anion gap is used to distinguish metabolic acidosis disorders. However, particularly in critically-ill patients, it may be beneficial to calculate the anion gap regardless in order to distinguish concomitant acid-base disorders.

The anion gap is:  

The albumin corrected anion gap (ACAG) is:  

Question #10-a

  • Yes, the Delta ratio should be calculated
  • No, the Delta ratio should NOT be calulated

Question #10-b

  • Yes, calculate the urinary anion gap
  • No, do NOT calculate the urinary anion gap

Question #11

  • Sodium Bicarbonate
  • Tromethamine (THAM)
  • Normal Saline Infusion
  • Hydrochloric Acid

Practice Case 3

Question #12

  • Acidosis
  • Alkalosis
  • Neither

Question #13

  • Respiratory Acidosis
  • Metabolic Acidosis
  • Respiratory Alkalosis
  • Metabolic Alkalosis

Question #14

  • Metabolic Acidosis with expected compensation
  • Metabolic Acidosis with UNexpected compensation
  • Respiratory Acidosis with expected compensation
  • Respiratory Acidosis with UNexpected compensation

Question #15

 

The anion gap is: 

The albumin corrected anion gap is: 

Question #16-a

  • Yes, the Delta ratio should be calculated
  • No, the Delta ratio should NOT be calculated

Question #16-b

The Delta ratio is:  

Question #16-c

  • Yes, the urinary anion gap should be calculated
  • No, the urinary anion gap should NOT be calculated

Question #17

  • Tromethamine (THAM)
  • Ammonium Chloride
  • Arginine Monohydrochloride
  • Hydrochloric Acid