Primary metabolic and respiratory acid-base disorders and their expected compensation, distinct from the sodium and potassium focus of the fluid and electrolyte deck.
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- What is the primary defect in metabolic acidosis?
- A primary decrease in plasma bicarbonate (HCO3-).
- What is the primary defect in metabolic alkalosis?
- A primary increase in plasma bicarbonate (HCO3-).
- What is the primary defect in respiratory acidosis?
- A primary increase in PaCO2 caused by hypoventilation.
- What is the primary defect in respiratory alkalosis?
- A primary decrease in PaCO2 caused by hyperventilation.
- In metabolic acidosis, the expected compensatory response is ____.
- hyperventilation to lower PaCO2
- In metabolic alkalosis, the expected compensatory response is ____.
- hypoventilation to raise PaCO2
- How do the kidneys compensate for respiratory acidosis?
- By increasing bicarbonate reabsorption and generation, raising plasma HCO3-.
- How do the kidneys compensate for respiratory alkalosis?
- By decreasing bicarbonate reabsorption, lowering plasma HCO3-.
- Which organ provides fast, minutes-scale compensation for a metabolic acid-base disorder?
- The lungs, by changing the respiratory rate.
- Which organ provides slow, days-scale compensation for a respiratory acid-base disorder?
- The kidneys, by adjusting bicarbonate handling.
- What formula predicts the expected PaCO2 in a simple metabolic acidosis?
- Winter's formula: PaCO2 = 1.5 x HCO3- + 8 (plus or minus 2).
- In metabolic acidosis, if the measured PaCO2 is higher than Winter's formula predicts, what does this indicate?
- A superimposed (concurrent) respiratory acidosis.
- In metabolic acidosis, if the measured PaCO2 is lower than Winter's formula predicts, what does this indicate?
- A superimposed (concurrent) respiratory alkalosis.
- In metabolic alkalosis, about how much does PaCO2 rise for every 1 mEq/L rise in HCO3-?
- About 0.7 mmHg.
- In acute respiratory acidosis, about how much does plasma HCO3- rise for every 10 mmHg rise in PaCO2?
- About 1 mEq/L.