Acid base disorders with case discussion

Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis

Acidosis
decreased pH

Alkalosis
increased pH

Metabolic acidosis
primary defect- decreased bicarbonate

Compensation - hyperventilation by lungs

Causes

High anion gap metabolic acidosis
DKA
lactic acidosis
renal failure
organic aciduria
aminoacidurias

Normal anion gap metabolic acidosis
Diarrhea
RTA
intestinal fistula


Metabolic alkalosis
primary defect- increased bicarbonate

Compensated by Respiratory mechanism- hypoventilation

causes

vomiting
upper git obstruction
adrenal tumor
Cushing syndrome
glucocorticoid excess
mineralocorticoid excess

Respiratory acidosis
primary defect- increased pCO2

Compensated by renal conservation of bicarbonate

Causes
pneumonia
COPD
asthma
Narcotics and sedatives
paralysis of respiratory muscles

Respiratory alkalosis
primary defect- decreased pCO2

Compensated by - renal excretion of bicarbonate

Causes
Hypoxia
High altitude
Hysteria
hyperventilation

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