Clinical Chemistry

Definitions

Acidemia

Alkalemia

pHarterial < 7.40

pHarterial > 7.44

Henderson-Hasselbalch equation
pH = pKa + log (base/acid)
s/p RBC transfusion and ABG calculation of oxygen saturation

–> misleading

<– tranfused RBC’s – low 2,3-DPG levels

Method of choice for detecting CO poisoning

Co-oximetry –> spectrophotometric device => measures absorbance of multiple wavelengths of light => oxyHgb,deoxyHgb,metHgb, COHgb

*except sulf-Hgb

Anion gap calculation

Anion gap = [Na] – ([Cl] + [HCO3])

normal<12

Corrected anion gap calculation

hypoalbuminemia –> mask anion gap

= [Na] – ([Cl] + [HCO3]) + 2.5(4-Albumin)

Osmolal gap calculation

Osm gap = osmmeasured – (2[Na]+[Gluc]/18+BUN/2.8)

nml < 10

Non anion gap acidosis

a/w?

hyperchloremic metabolic acidosis

Metabolic acidosis and alkalosis

pH and [HCO3] –> which direction?

same direction

acidosis –> bicarb < 25mEq/L

alkalosis–> bicarb > 25mEq/L

“M=saMe”

Respiratory acidosis and alkalosis

pH and [HCO3] –> which direction?

opposite direction

acidosis –> pCO2 > 44mm Hg

alkalosis –> pCO2 < 40mm Hg

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