acid-base disorder/ccm board review

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Page 1: Acid-Base Disorder/CCM Board review

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 Na140

Cl105

HCO3 

10

unmeasured anions

(Proteins, SO4, PO4,

organic anions)

unmeasured

cations

(K, Ca, Mg){

 Na140

HCO3 

10

Cl120

  }

}Lactate

15

Anion

Gap

10Anion

Gap25

Anion GapAcidosis

HyperchloremicAcidosis

Normal

Gap 10

Normal

Gap 10

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!""#$%&' )$ !&*+,-%./M

!>*$> N%" 3/)%H$2*& !&*+$.*.

M ethanol U remia 

D iabetic or alcoholic ketoacidosis/ Drugs 

P henformin/Paraldehyde/Pyroglutamic Acid/Propylene Glycol 

I nh/Iron 

L actic acidosis ( L & D ) 

E thylene glycol S alicylate

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!""#$%&' )$ !&*+,-%./M

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G lycols O xoproline 

L - lactic acidosis 

D - lactic acidosis

M ethanol 

A spirin 

R enal failure K etoacidosis

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E%&J& !&*+$.*.

•  Etiology of Lactic Acidosis 

•  Drugs 

$  biquanides$  nucleoside analogs

propylene glycol$ 

propofol

$  !-agonists  

$  linezolid$  aspirin

cocaine

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Time&

 

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Acidosis secondary to the metabolism of

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G7),#-:.*#,B0- _,&$<*.0- 8-0C*202

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excretion

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excretion

N e g a t  i  v e

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Fractional

Excretion

HCO3 >15%

Urine pH > 5.5

Positive Urine AG Negative

Urine AG

Urine pH < 5.5

(pH maybe > 5.5)

Positive Urine AG

High urine osmole gap

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