Acid Base Disorder

From Anvita Health Wiki

Contents 1 More Specific Terms 2 Introduction 3 Classification 4 Interpretation 5 More General Terms 6 Additional Terms 7 References

More Specific Terms

• metabolic acidosis
• metabolic alkalosis
• mixed acid-base disorder
• respiratory acidosis
• respiratory alkalosis

Introduction

• Systematic approach:
• What is the primary disturbance?
• Is the compensation appropriate?
• What is the anion gap?
• Is the change in anion gap due to the change in [[[Hco3- | HCO3-]]]?

Classification

• acidosis: pH < 7.38

• metabolic acidosis: [[[Hco3- | HCO3-]]] < 24 meq/L
• respiratory acidosis: PaCOs > 40 mm Hg

• alkalosis: pH > 7.42

• metabolic alkalosis: [[[Hco3- | HCO3-]]] > 24 meq/L
• respiratory alkalosis: PaCO2 < 40 mm Hg
  

Interpretation

• Anion gap:

• when the primary disturbance is a metabolic acidosis, the anion gap indicates the presence of unmeasured anions
• when the primary disturbance is other than metabolic acidosis, an increased anion gap reveals a hidden metabolic acidosis
• a narrow anion gap suggests unexpected cations (i.e. immunoglobulins in multiple myeloma)

More General Terms

• metabolic disease

Additional Terms

• acid-base balance

References

- Medical Knowledge Self Assessment Program (MKSAP) 14, American College of Physicians, Philadelphia 2006 acid-base disorder