2ND ASSESSMENT Flashcards

1
Q

Complete the following statements:
1-3) As oxygen is delivered by the red blood cells to the tissues, the (1) ______ charged (2) _____ fits into a
(3)______ charged crevice formed by the four chains of the hemoglobin molecule.

A

(1) negatively charged
(2) 2,3-BPG fits into a
(3) positive charged

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2
Q
4-5) In the peripheral tissues, (4) \_\_\_\_\_\_ diffuses out of the red blood cells, accompanied by the
exchange of (5) \_\_\_\_\_ into the red blood cells.
A

(4) bicarbonates

(5) chloride

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3
Q

6-8) (6) ____ diffuses into red blood cells where it reacts with water to form (7) ______, which after catalysis, readily splits into hydrogen ions and (8) _____

A

(6) CO2
(7) carbonic
(8) bicarbonate

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4
Q

In the presence of specifically the amino acid, (9) _____, the dissociation & excretion of hydrogen
ions from dihydrogen phosphate in the kidney is important , with a pKa of (10) ____.

A

(9) glutamine

(10) 6.8

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5
Q

The (11) ____ structure in the form of (12) _____ has a high affinity for oxygen, while the (13)____ structure, in the form of (14) _____ has a low affinity for oxygen.

A

(11) relax
(12) oxyhemoglobin
(13) taut
(14) deoxyhemoglobin

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6
Q

The pO2 value in the peripheral tissues:

A

40 mmHg

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7
Q

Normally the levels of bicarbonate and carbonic acid are maintained at a ratio of ____________.

A

20:1

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8
Q

Once the hemoglobin molecule has started binding with oxygen, its affinity for the succeeding oxygen molecules increases. This is known as the?

A

cooperative effects

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9
Q

An increased P50 means that the affinity of hemoglobin with oxygen.

A

lowers

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10
Q

This is the ONLY condition that allows the Physician to do Arterial Blood Extraction:

A

cannulation of the vessel anticipated

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11
Q
Physiologic effects of alkalosis EXCEPT:
• arrhythmias
• increased neuromuscular excitability
• increased bone resorption
• inhibition of respiratory drive
A

increased bone resorption

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12
Q
This is NOT among the causes of Hypoventilation leading to Respiratory Acidosis:
• neuromuscular disorders
• disorders of the chest wall
• acute airway obstruction.
• chronic obstructive lung disease
• acid volume contraction
A

acid volume contraction

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13
Q

Given an arterial blood with pCO2 of 40mmHg and a total of CO2 of 30mmol/L. Determine the HCO3- concentration.

A

14.6 mmol/L

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14
Q

A patient just turned 22years old today. He asked you as his Attending Physician how many liters of Free Pure Oxygen has he inhaled thus far:

A

4,416,500L

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15
Q

This is NOT among the physiologic effects of acidosis:

A

hypokalemia

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16
Q
Respiratory alkalosis is very commonly induced by the following EXCEPT:
• liver failure
• aspirin intoxication
• sepsis
• CNS depression
A

CNS depression

17
Q

Which of the following pathophysiologic processes will NOT result to Metabolic acidosis?
• increased in what body perceives as stressors
• increased loss of bicarbonate
• increased production of nonvolatile acids
• decreased renal excretion of acid

A

decreased renal excretion of acid

18
Q

This is the major product of the Luebering-Rapoport pathway which is predominant in red blood cells.

A

2,3 bis-phosphoglycerate

19
Q

P50 values refer to the following EXCEPT:
• the other oxygen molecule has been delivered to the tissues
• oxygen partial pressure in the lungs
• the affinity of hemoglobin with oxygen
• the partial pressure at which hemoglobin is half-saturated with oxygen

A

the other oxygen molecule has been delivered to the tissues

20
Q

In the collecting tubule, hydrogen ion secretion is mediated by a H+ ATPase pump in the luminal membrane and a Cl-HCO3- exchanger in the basolateral membrane, through the following process:

A

Type A cells secrete H+ into tubular lumen

21
Q

Match each item to a choice:
chronic respiratory alkalosis
acute respiratory acidosis,
chronic respiratory acidosis

elevated PaCO2 & low pH
• low PaCO2 & pH level near normal
• elevated PaCO2 & pH near normal

A

elevated PaCO2 & low pH - acute respiratory acidosis
• low PaCO2 & pH level near normal - chronic respiratory alkalosis
• low PaCO2 & high pH
• elevated PaCO2 & pH near normal - chronic respiratory acidosis

22
Q
Normal Ranges.
pO2:
HCO3-: 
O2 sat: 
pH:
pCO2: 
Choices:
• 24-26mEq/L
• 7.35-7.45
• 95-100%
• 80-100mmHg
• 35-45mmHg
A
pO2: 80-100mmHg
HCO3-: 24-26mEq/L
O2 sat: 95-100%
pH: 7.35-7.45
pCO2: 35-45mmHg
23
Q

pH<7.4 HCO3>26 PCO2>45 DIAG?

Disorders of Hydrogen Ion Homeostasis:

A

Respiratory Acidosis Compensated

24
Q

pH<7.4 HCO3>26 PCO2>45 DIAG — CAUSES?

What is the CAUSE?

A

pneumonia, Chronic Obstructive Pulmonary Disease

25
Q

pH<7.4 HCO3>26 PCO2>45 DIAG- CAUSES - COMPEN RES

What is the Compensatory Responses?

A

reabsorption of bicarbonates

26
Q

pH>7.4 HCO3<24 PCO2<35

What is the Diagnosis?

A

Respiratory Alkalosis Compensated

27
Q

pH>7.4 HCO3<24 PCO2<35

What are the causes?

A

Hyperventilation, pain, anxiety

28
Q

pH>7.4 HCO3<24 PCO2<35

What is the Compensatory Responses?

A

excretion of bicarbonates

29
Q

pH<7.4 HCO3<24 PCO2<35

What is the Diagnosis?

A

Metabolic Acidosis Compensated

30
Q

pH<7.4 HCO3<24 PCO2<35

What are the causes?

A

Chronic vomiting, low blood potassium

31
Q

pH<7.4 HCO3<24 PCO2<35

What is the Compensatory Responses?

A

hyperventilation

32
Q

pH>7.4 HCO3>26 PCO2>45

What is the Diagnosis?

A

Metabolic Alkalosis Compensated

33
Q

pH>7.4 HCO3>26 PCO2>45

What are the causes?

A

Kidney failure, shock, diabetic ketoacidosis

34
Q

pH>7.4 HCO3>26 PCO2>45

What is the Compensatory Responses?

A

hypoventilation