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Acid-Base Disturbances: Types and Compensation - Anatomy and Physiology

  1. Classify: pH 7.28, PaCO2 30 mmHg, HCO3- 14 mEq/L.
    Metabolic acidosis with partial respiratory compensation. Low HCO3- is the cause; the low PaCO2 is compensation, and pH is still low.
  2. Classify: pH 7.52, PaCO2 28 mmHg, HCO3- 24 mEq/L.
    Uncompensated respiratory alkalosis. Low PaCO2 explains the high pH, and HCO3- is still normal.
  3. Which acid-base disturbance results from severe, prolonged diarrhea?
    Metabolic acidosis. Intestinal fluid is rich in bicarbonate, so losing it lowers plasma HCO3-.
  4. What is the normal range of arterial blood pH?
    7.35 to 7.45. Below 7.35 is acidemia; above 7.45 is alkalemia.
  5. How does the body compensate for a metabolic acidosis?
    By hyperventilating (deep, rapid breathing) to lower PaCO2, which raises pH back toward normal within minutes.
  6. An opioid overdose depresses breathing. Which acid-base disturbance develops?
    Respiratory acidosis. Hypoventilation retains CO2, raising PaCO2 and lowering pH.
  7. How do the kidneys compensate for a chronic respiratory acidosis?
    They increase H+ secretion and bicarbonate reabsorption and generation, raising plasma HCO3-. This takes days to develop.
  8. Which acid-base disturbance results from prolonged vomiting of gastric contents?
    Metabolic alkalosis. Losing stomach HCl removes acid, leaving excess bicarbonate in the blood.
  9. What is the formula for the serum anion gap?
    Anion gap = Na+ minus (Cl- plus HCO3-). A raised gap in metabolic acidosis points to added unmeasured acids such as ketoacids or lactate.
  10. What defines a fully compensated acid-base disturbance on an arterial blood gas?
    pH is back within 7.35 to 7.45 while both PaCO2 and HCO3- remain abnormal.
  11. Classify: pH 7.30, PaCO2 55 mmHg, HCO3- 25 mEq/L.
    Uncompensated respiratory acidosis. Low pH with high PaCO2 makes CO2 the cause, and a normal HCO3- shows no renal compensation yet.
  12. Classify: pH 7.50, PaCO2 48 mmHg, HCO3- 34 mEq/L.
    Metabolic alkalosis with partial respiratory compensation. High HCO3- is the cause; hypoventilation raised PaCO2 but pH is still high.

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