Acid Base Balance Dr.

Ahmad Mowafy

nephrology

Acid base balance

Acid base balance

acid base balance
source
Post graduates

pre graduates

source
arrhythmias

in capsule series

Acid base balance

Two organs
PH
PH
PH

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Organs

Acid Base Balance Dr. Ahmad Mowafy

... Lung .... Organ

PH
PH

...
PH

two organs
control
Kidney

PH

respiratory alkalosis

Kidney

respiratory acidosis

Lung

metabolic alkalosis

lung
kidney

Lung

Metabolic acidosis

kidney

PH
Acidosis
PH
CO2

CO2
CO2

Alkalosis

wash

CO2
stimulation of respiratory centre
Acidosis
CO2

wash

deep and rapid

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Acidosis
respiration
CO2
Acidosis
CO2
wash of CO2
respiration

Acidosis

Acid Base Balance Dr. Ahmad Mowafy

alkalosis
Inhibition respiratory centers
CO2
retention of CO2
respiration
Lung
Acid base balance
kidney
Acid base balance

Alkalosis

kidney

acid base balance

Acid base balance

Acid base balance

hydrogen ions
HCO3
Acid base balance
H ions
HCO3

secretion

tubules
urine
tubules

re absorption

lumen
Lumen
lumen
urine

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Acid Base Balance Dr. Ahmad Mowafy

Urine
Urine

re absorption

bicarbonate
alkaline

reserve

Kidney

kidney

Hypokalemia

arrhythmias
H ions

Hypo kalemia

Alkalosis
alkalosis

hypo kalemia

hypo kalemia
hydrogen ions
H ions

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Acid Base Balance Dr. Ahmad Mowafy

H ions
Hyper kalemia

H ions
acidosis

H ions

Hyper kalemia

alkalosis
hypo kalemia
Acidosis
Hyper kalemia

H ions
tubules

toxic

H ions

H ions

tubules
tubules

H ions

H ions

tubules

NH4

tubules

NH3
tubules
Toxic
tubules

NH3
NH4

NH3

hypo kalemia

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toxic

Acid Base Balance Dr. Ahmad Mowafy

HCO3

alkalosis
alkalosis
alkalosis
kidney
kidney
kidney
kidney

kidney

kidney

kidney

Metabolic alkalosis
kidney

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Acid Base Balance Dr. Ahmad Mowafy

saline

Acid base balance

respiratory

respiratory acidosis

Metabolic alkalosis

Metabolic acidosis
alkalosis

respiration

Metabolic Acidosis
metabolic acidosis

kidney

metabolic acidosis
etiology
Metabolic acidosis
Chronic renal failure
H ions retention
acidosis
acidosis

acidosis

shock

Anemia

acidosis
diabetic keto acidosis
keton bodies
acteo acetic acid
heart failure
acidosis
Heart failure
Low cardic out put
heart failure
Low cardic out put
Heart failure
ischaemia
Low cardic out put
Hypoxia
ischaemia
hypoxia
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Acid Base Balance Dr. Ahmad Mowafy

an aerobic pathway
Metabolism
lactic acid
an aerobic pathway
acid

an

an aerobic pathway
Lactic acidosis
diabetes

Hypoxia

acidosis
Heart failure
Hypoxia
Ischaemia
lactic acidosis
aerobic pathway

lactic acidosis

tissue hypoxia
diarrhea
diarrhea

alkali
renal tubular acidosis

kidney

acute tubular acidosis

Isolated defect
kidney

Kidney

Isolated defect

defect

H ions
acidosis

acidosis

Hyper kalemia
hyper kalemia
etiology
clinical picture
investigation
treatment

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Acid Base Balance Dr. Ahmad Mowafy

clinical picture

clinical picture
clinical picture of the cause
clinical picture of the cause

Metabolic acidosis
nephrology
endocrine
cardiology

chronic renal failure

Diabetic keto acidosis
Heart failure
GIT
Diarrhea
Isolated tubular acidosis

clinical picture of the cause

differential diagnosis
clinical pictures
PH
hyper ventilation
Hyper ventilation
acidosis
hyper ventilation
rapid deep respiration Hyper ventilation
Wash of CO2
CO2

Investigations

Acid base balance

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Acid Base Balance Dr. Ahmad Mowafy

PH
acidosis
PH

respiratory

PH
alkalosis

Metabolic

HCO3

CO2

CO2
CO2

HCO3
PH
Normal
HCO3
Lung
100%
kidney

normal

CO2
Lung
CO2

HCO3

CO2 normal

PH
Metabolic acidosis
HCO3
Metabolic
HCO3
HCO3
acidosis
Metabolic CO2
Normal
CO2
compensation

CO2
compensation

CO2

CO2
Metabolic

CO2
Kidney
HCO3
PH
Normal
CO2
compensation
HCO3
PH
Metabolic acidosis

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Acid Base Balance Dr. Ahmad Mowafy

Metabolic alkalosis
metabolic acidosis
Normal

compensation

CO2

compensation
wash of CO2

CO2
kidney

CO2

compensation
compensation

CO2

HCO3
CO2
HCO3

HCO3
H

Hypo kalemia

PH

PH
HCO3

PH
CO2

hyper kalemia
alkalosis alkalosis

Hyper kalemia

HCO3

acidosis
hypo kalemia

acidosis acidosis
acidosis

hyper kalemia

acidosis
H

acidosis

H
H ions

Parallel to each other

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Acid Base Balance Dr. Ahmad Mowafy

H ions
H ions

acidosis

Hyper kalemia

Hyper kalemia

acidosis
hyper kalemia
acidosis
acidosis
hyper kalemia
Hypo kalemia
alkalosis
alkalosis
Hypo kalemia

Investigations
investigations for the cause
Diabetic keto

chronic renal failure

heart failure

acidosis

differential diagnosis

treatment
treatment
N.B.

treatment

treatment

treatment of metabolic acidosis

N.B.
N.B.
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Acid Base Balance Dr. Ahmad Mowafy

treatment of the cause

chronic renal failure
Diabetic keto acidosis
acidosis
NaHCO3
NaHCO3
N.B.

N.B.

chronic renal failure

Metabolic acidosis
acidosis

NaHCO3
acidosis

tetany

chronic renal failure

Hypo calcemia
chronic renal failure
acidosis
hypo calcemia
tetany
Ionized calcium non ionized calcium

hypo calcemia

acidosis

Calcium

DKA

tetany
acidosis

NaHCO3

DKA

chronic renal failure

N.B.

metabolic acidosis

endocrine
precipitating factors

saline
not essential

acidosis

DKA

diabetic keto acidosis

Logic
bicarbonate
essential
acidosis

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Acid Base Balance Dr. Ahmad Mowafy

diabetic keto acidosis

acidosis
sever alkalosis
alkalosis
alkalosis
alkalosis

alkalosis
diabetic keto acidosis
essential
sever
diabetic keto acidosis

bicarbonates are not essential

metabolic acidosis

metabolic alkalosis
Metabolic acidosis
source
metabolic alkalosis
etiology
metabolic alkalosis
Metabolic alkalosis

gastroectomy
Metabolic alkalosis
hypo kalemia
alkalosis
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Acid Base Balance Dr. Ahmad Mowafy

endocrine

Metabolic alkalosis
hypo kalemia
Hypo kalemia vomiting , gastroectomy
aspiration diuretics conn's cushing
Hypo kalemia
etiology

clinical pictures
clinical pictures
conn's
tetany

cushing

Metabolic alkalosis
ca hypo para thyroidism

pictures of the cause

tetany
tetany

metabolic alkalosis
tetany
metabolic alkalosis
normo calcemic tetany
tetany
tetany
Normo calcemic
alkalosis
Mg tetany
see endocrine
tetany
tetany
metabolic alkalosis
Metabolic alkalosis

Investigations

PH
HCO3
CO2
alkalosis
metabolic alkalosis
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PH
HCO3

Acid Base Balance Dr. Ahmad Mowafy

CO2

alkalosis

normal

CO2

alkalosis
hypo kalemia
hyper kalemia
alkalosis

alkalosis
acidosis

Investigations for the cause

treatment

kidney

kidney

wash

type 2

hypo ventilation

Blue bloter

Respiratory acidosis
respiratory acidosis
chest
respiratory acidosis
acidosis
respiratory acidosis
CO2
CO2 retention
CO2 retention
alkalosis
CO2
CO2
respiratory acidosis
Hypo ventilation
chest
type 2
COPD
chest
hypo ventilation
COPD
type 2
investigations
COPD
COPD
respiratory acidosis
respiratory alkalosis

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Acid Base Balance Dr. Ahmad Mowafy

dyspnea
dyspnea

CO2

wash

cardiology
pregenant female

CO2 wash

CO2

dyspnea
chest
Pulmonary congestion

dyspnea
dyspnea
respiratory alkalosis
respiratory alkalosis
Hyper ventilation
dyspnea
hyper ventilation
dyspnea
left sided heart failure
dyspnea
ascites
respiratory alkalosis
clinical picture
clinical picture of the cause and tetany

dyspnea
tetany

Acid base balance

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Acid Base Balance Dr. Ahmad Mowafy

http://www.facebook.com/dr.tafreegh

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