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Acid-Base Disorders

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Nephrology & Urology | Medicine (MD/DO) School Study Aid

Acid-Base Disorders
14 Picmonics to Learn | 30 mins
Respiratory Alkalosis
Hyperventilation
High Altitude
Aspirin
Restrictive Lung Disease
Pulmonary Embolism
Pregnancy
Progesterone
Rib Fracture
Anxiety
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2 mins
Respiratory Alkalosis Interventions
Treat Underlying Cause
Mechanically Ventilated Patients
Decrease Tidal Volume and/or Respiratory Rate
Give Adequate Pain Control and Sedation
Hyperventilation Syndrome
Sedatives
Antidepressants
Considerations
Compensatory Drop in Serum Bicarbonate
Calming Breathing Exercises
Correct CO2 Slowly
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2 mins
Respiratory Acidosis
Hypoventilation
Increased PaCO2 > 45
Barbiturates Depress Central Respiratory Center of Brain
Opioids Depress Central Respiratory Center of the Brain
Airway Obstruction
Respiratory Muscle Weakness/Paralysis
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3 mins
Respiratory Acidosis Interventions
Improve Respiration
Pharmacologic Interventions
Bronchodilators
Respiratory Stimulants
Drug Antagonists
Nonpharmacologic Interventions
Oxygen
Assisted Ventilation
Prevent Complications
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1 min
Metabolic Alkalosis
Diuretic use
Vomiting
Antacid
Hyperaldosteronism
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26 secs
Metabolic Alkalosis Interventions
Interventions
Treat Underlying Cause
Stop Potassium (K+) Wasting Diuretics
Spironolactone
Acetazolamide
IV Fluids
Sodium Chloride
Replace Potassium (K+)
Considerations
Monitor Respiratory Rate
Monitor Heart Rate
Seizure Precautions
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2 mins
Normal Gap Metabolic Acidosis
HARD-ASS
Hyperalimentation
Addison's Disease
Renal Tubular Acidosis
Diarrhea
Acetazolamide
Spironolactone
Saline Infusion
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2 mins
Anion Gap Metabolic Acidosis
Pathophysiology
Increased Anion Gap
MUDPILES
Methanol
Uremia
Diabetic Ketoacidosis (DKA)
Propylene Glycol
Isoniazid or Iron
Lactic Acid
Ethylene Glycol
Salicylates
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1 min
Metabolic Acidosis Interventions
Interventions
Raise Plasma pH > 7.20
Treat Underlying Cause
Sodium Bicarbonate
Considerations
Follow ABGs
Continuously Monitor Patient
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2 mins
Fanconi Syndrome Characteristics
Pathophysiology
Resorption Defect in Proximal Tubule
Signs and Symptoms
Hypophosphatemia
Rickets
Osteomalacia
Hypokalemia
Metabolic Acidosis
Type 2 Renal Tubular Acidosis
Treatment
Treat Underlying Disorder
Bicarbonate
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1 min
Fanconi Syndrome Causes
Hereditary Causes
Cystinosis
Dent's Disease
Wilson's Disease
Oculocerebrorenal (Lowe) Syndrome
Galactosemia
Hereditary Fructose Intolerance
Glycogen Storage Diseases
Tyrosinemia
Acquired and Medication Causes
Tenofovir
Heavy Metals
Expired Tetracyclines
Cisplatin
Gentamycin (Aminoglycosides)
Valproate Sodium
Multiple Myeloma
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2 mins
Distal Renal Tubular Acidosis (Type I)
Pathophysiology
Distal Tube
Defect in H+ Secretion
Labs
Increased Urinary pH
Urinary pH >5.5
Hypokalemia
Causes
Amphotericin B Toxicity
Autoimmune Disease
Lithium
Obstruction Of The Urinary Tract
Complication
Kidney Stones
Treatment
Bicarbonate
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3 mins
Type 2 Renal Tubular Acidosis
Proximal Tubule
Pathophysiology
Inability To Reabsorb Bicarbonate
ETIOLOGY
Fanconi Syndrome
Sporadic Type
Familial Types
Autosomal Recessive
Acetazolamide
Characteristics
Decreased Urinary pH
Hypokalemia
Treatments
Treat Underlying Disorder
Alkali Therapy
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4 mins
Renal Tubular Acidosis Type 4
Characteristics
Aldosterone Resistance
Decreased Aldosterone Production
Causes Of Hypoaldosteronism
Addison’s Disease (Primary Adrenal Insufficiency)
Hyporeninism
Causes Of Aldosterone Resistance
Trimethoprim-Sulfamethoxazole
Potassium Sparing Diuretics
Labs
Hyperkalemia
Low Urine pH
Diminished Ammonium (NH4) Urinary Excretion
Treatment
Furosemide
Fludrocortisone
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5 mins

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