Page 1 of 3: Library: ACID –BASE FUNDA’S

drkbravva · Credits: 24006 My Scrapbook My Reading List 1 Books

-----Acidosis----------------->
(Lt.side) CO2 + H2O--------( H2CO3--------( H+ + HCO3- (Rt.side)
<---Alkalosis------------------

EXPECT FOR THE COMPENSATION, THE BASIC RULE
= ACIDOSIS= DECREASED PH / INCREASE [H+] / LOSS OF HCO3-
= ALKALOSIS= INCREASED PH / DECREASED [H+] / Decreased PCO2

Lung Compensate for==

For Metabolic Acidosis by Decreasing PCO2 (by Hyperventilation)
(2) For Metabolic Alkalosis by Increasing PCO2 (by Hypoventilation)

Kidney Compensate for==
(1) For Respiratory Acidosis by Increasing HCO3- Reabsorption.
(2) For Respiratory Alkalosis by Decreasing HCO3- Reabsorption.

Always look for [HCO3-] / [PCO2] ==

(1) Uncompensated / simple conditions==( any one of these can be the fes. But only one of these…)
= Normal/ Increase
= Normal/ Decrease
= Increase/ Normal
= Decrease/ Normal

Compensated conditions==
= Increase/ Increase
= Decrease/ Decrease

Mixed i.e. (Both Respiratory and metabolic Acidosis or Alkalosis)==
i.e. Metabolic Acidosis and Respiratory Acidosis=[HCO3-]/ PCO2== Decrease/ Increase
Metabolic Alkalosis and Respiratory Alkalosis=[HCO3-]/ PCO2== Increase/ Decrease
Things to look for (in order)=

PH (N=7.38-7.44)

PCO2 (N=35—45)

[HCO3-] (N=21—30)

[HCO3-]/ PCO2

Respiratory Acidosis=simple/uncompensated

PH (N=7.38-7.44) == Decrease

PCO2 (N=35—45)== Increase

[HCO3-] (N=21—30)== Normal

[HCO3-]/ PCO2== Normal/ Increase

Respiratory Acidosis= compensated

PH (N=7.38-7.44)== Normal

PCO2 (N=35—45)== Increase

[HCO3-] (N=21—30)== Increase

[HCO3-]/ PCO2== Increase/ Increase

Respiratory Alkalosis=simple/uncompensated
PH (N=7.38-7.44)== Increase

PCO2 (N=35—45)== Decrease

[HCO3-] (N=21—30)== Normal

[HCO3-]/ PCO2== Normal/ Decrease

Respiratory Alkalosis= compensated
PH (N=7.38-7.44)== Normal

PCO2 (N=35—45)== Decrease

[HCO3-] (N=21—30)== Decrease

[HCO3-]/ PCO2== Decrease/ Decrease

Metabolic Acidosis=simple/uncompensated
PH (N=7.38-7.44)== Decrease

PCO2 (N=35—45)== Normal

[HCO3-] (N=21—30)== Decrease

[HCO3-]/ PCO2== Decrease/ Normal

Metabolic Acidosis= compensated
PH (N=7.38-7.44)== Normal

PCO2 (N=35—45)== Decrease

[HCO3-] (N=21—30)== Decrease

[HCO3-]/ PCO2== Decrease/ Decrease

Metabolic Alkalosis=simple/uncompensated
PH (N=7.38-7.44)== Increase

PCO2 (N=35—45)== Normal

[HCO3-] (N=21—30)== Increase

[HCO3-]/ PCO2== Increase/ Normal

Metabolic Alkalosis=Compensated
PH (N=7.38-7.44)== Normal

PCO2 (N=35—45)== Increase

[HCO3-] (N=21—30)== Increase

[HCO3-]/ PCO2== Increase/ Increase

_____________________________________________________________

if some wrong pls.....correct me.......or u can a few tips / tricks which i may not be knowing.........

drkbravva · Credits: 24006 My Scrapbook My Reading List 1 Books

PLS ADD SOME MORE TIPS / TRICKS.............

drkbravva · Credits: 24006 My Scrapbook My Reading List 1 Books

Q=interpret the lab data..
ABG:- PH=7.45, PO2=125, PCO2=12

Serum :- Na+=138, k+=4.8, Cl-=102, Hco3-=8

the acid base diusturbance is best characterised by

which of the folllowing descriptions--
(a) acute resp. alkalosis
(b) chronic resp. alkalosis
(c) acute metabolic acidosis
(d) mixed metabolic acidosis & resp.alkalosis

drsmita_s · Credits: 18609 My Scrapbook

the answer is b) chronic resp. alkalosis.

this is a beautiful way to remember this topic dr.bravva. thanx.

vineetgsvm · Credits: 122703 My Scrapbook

agreed chr resp alkalosis

flowerchildn · Credits: 7753 My Scrapbook

well do add on dr
its one ogf the most needed topics of discussion

drsmita_s · Credits: 18609 My Scrapbook

these acid base questions can be solved in three parts

1 acidosis / alkalosis
2 compensated /uncompensated
3 metabolic or respiratory

1 is easy to decide when uncompensated:
[quote]EXPECT FOR THE COMPENSATION, THE BASIC RULE
= ACIDOSIS= DECREASED PH / INCREASE [H+] / LOSS OF HCO3-
= ALKALOSIS= INCREASED PH / DECREASED [H+] / Decreased PCO2 [quote]

2 is easy sincce pH willb normal and [quote]look for [HCO3-] / [PCO2] == Compensated conditions==
= Increase/ Increase
= Decrease/ Decrease
[quote]

3 repiratory or metabolic is easy to decide when uncompensated , but how to find out in compensated cases that which is primary abnormality and which is compensatory phenomenon? look for urself, how values r same in these cases :
[quote]Respiratory Acidosis= compensated

PH (N=7.38-7.44)== Normal

PCO2 (N=35—45)== Increase

[HCO3-] (N=21—30)== Increase

[HCO3-]/ PCO2== Increase/ Increase

Metabolic Alkalosis=Compensated
PH (N=7.38-7.44)== Normal

PCO2 (N=35—45)== Increase

[HCO3-] (N=21—30)== Increase

[HCO3-]/ PCO2== Increase/ Increase [quote]

and at this
[quote] Respiratory Alkalosis= compensated
PH (N=7.38-7.44)== Normal

PCO2 (N=35—45)== Decrease

[HCO3-] (N=21—30)== Decrease

[HCO3-]/ PCO2== Decrease/ Decrease

Respiratory Alkalosis= compensated
PH (N=7.38-7.44)== Normal

PCO2 (N=35—45)== Decrease

[HCO3-] (N=21—30)== Decrease

[HCO3-]/ PCO2== Decrease/ Decrease [quote]
ithink 80% of this topic is understood except for this concept. pardon me if i have confused u but please help!!

drsmita_s · Credits: 18609 My Scrapbook

rxpg team please edit this post, i had tried to quote from dr bravva's post but it is not done and the whole thing looks more confusing.

npshades · Credits: 809 My Scrapbook

just in nut shell friends

thanks a lot drbravva for ure nice notes

METABOLIC FORM OF ACIDOSIS/ALKALOSIS is related with Hco3- ion

RESPIRATORY FORM OF ACIDOSIS/ALKALOSIS ia associated with pco2[partial pressure of corbondioxide]

METABOLIC FORM OF DERANGEMENTS:
if hco3- is increased and given ph range is towards alkalosis[increased ph] we can say it as METABOLIC ALKALOSIS[ compensation here is by increase in pco2 by the lungs]

if given hco3- is decreased and ph is acidic[idecreased ph] it is METABOLIC ACIDOSIS[compensation here is by retaining in hco3-by the kidney]

RESPIRATORY FORM OF DERANGEMENTS:

IF PH IS DECREASED[acidic ph] and if it is associated with increase in pco2 it is RESPIRATORY ACIDOSIS[compensation here is by retaining hco3 ions]

IF PH IS INCREASED[alkalosis range ph] and if it is associated with decreased pco2 it is RESPIRATORY ALKALOSIS[compensation is by losing the hco3- ions by the kidney]

SLIGHTLY CONFUSING
BUT NO PROBLEM WITH THEM
TAKE CARE AND HAVE A GREAT TIME FRIENDS
HAPPY NEW YEAR

drkbravva · Credits: 24006 My Scrapbook My Reading List 1 Books

Finally, everytime we are dealing with an acid base disorder, we have to check for appropriate compensations of the primary disturbance, as to be able to distinguish simple from combined acid-base disorders, which are very frequent in ICU patients. The following formulas summarize this knowledge :

Metabolic Acidosis :
PCO2 = ( 1.5 x HCO3 ) + 8

Metabolic Alkalosis :
PCO2= ( 0.7 x HCO3 ) + 21

Respiratory Acidosis :
Acute - HCO3 = [ ( PCO2 - 40 ) / 10 ] + 24
Chronic - HCO3 = [ ( PCO2 - 40 ) / 3 ] + 24

Respiratory Alkalosis :
Acute - HCO3 = [ ( 40 - PCO2 / 5 ) ] + 24
Chronic - HCO3 = [ ( 40 - PCO2 ) / 2 ] + 24

ref---http://www.medstudents.com.br/terin/terin5.htm

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