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What is the main metabolic reaction affecting pH, enzyme?
- CO2 <--> H+ + HCO3-
- Carbonic Anhydrase.
What is normal pH, PCO2, HCO3-?
- pH: 7.4
- PCO2: 40 mmHg
- HCO3-: 24.
What causes respiratory acidosis?
Decreased alveolar ventilation (hypoventilation) -> increase PaCO2.
For every 10mmHg rise in PaCO2 there is a pH change, HCO3-?
- pH: decreases 0.08
- HCO3-: increases 1mM/L.
What causes respiratory alkalosis?
For every 10mmHg fall in PaCO2 there is a pH change, HCO#-?
- pH: increases 0.08
- HCO3-: decreases 2mM/L.
What causes metabolic acidosis?
Gain in fixed acid (or loss in bicarb).
What are the three main causes of metabolic acidosis?
- Increased production of acid (lactic acidosis, ketoacidosis)
- Bicarb loss (RTA II, diarrhea)
- Inability to secrete acid (RTA I, acute and chronic renal disease).
What is the expected (decreased) PCO2 in respiratory compensation of metabolic acidosis?
- PCO2= 1.5(HCO3-)+8.
What is the expected change in PCO2 (increase) in respiratory compensation of metabolic alkalosis?
Increase of 0.7mmHg PCO2 per 1mEq/L rise in HCO3-.
What is a normal anion gap?
10 +/- 2.
What is a mnemonic for anion gap acidosis?
- M: methanol
- U: Uremia
- D: DKA
- P: Paraldehyde
- I: Isoniazid/Iron
- L: Lactic acid
- E: Ethanol
- S: Salicylates
What three conditions will not widen the anion gap?