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Diagnostic Methods - Medical Lab > ABG > Flashcards

ABG Flashcards

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USMLE® Step 1 flashcards
1
Q

What does pH measure in the blood?

A

Acidity or Alkalinity

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2
Q

What is the normal blood pH range?

A

7.35 to 7.45

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3
Q

The more H+ in the blood the ____ the pH

A

Lower (acidic)

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4
Q

The less H+ in the blood the ____ the pH

A

Higher (alkaline)

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5
Q

In an Acidic State there is either too much _____ or too little ____

A

Too much PaCO2; too little HCO3

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6
Q

In an Alkalotic State there is either too much _____ or too little ____

A

Too little PaCO2; too much HCO3

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7
Q

In an Acidic State what body functions begin to change?

A

Weak cardiac contractions, decreased vascular response to catecholamines, diminshed response to some meds

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8
Q

In an Alkalotic State what body functions are interfered with?

A

Tissue oxygenation, neuromuscular, and neurological functioning

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9
Q

Blood pH changes in according to the level of which acid?

A

Carbonic Acid (H2CO3)

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10
Q

What is the compensation for too much or too little Carbonic Acid?

A

Increase or decrease in rate and depth on ventilation

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11
Q

How long does the “quick compensation” of ventilatilatory change last for

A

1-3 minutes

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12
Q

What are the two buffers systems?

A

Respiratory buffer, Renal buffer

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13
Q

Carbonic Acid is part of which buffer system?

A

Respiratory

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14
Q

What is the acid involved in the respiratory buffer system?

A

Carbonic Acid (H2CO3)

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15
Q

What is the base involved in the Renal buffer system?

A

Bicarbonate (HCO3)

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16
Q

What do the kidneys excrete or retain as part of the Renal buffer system?

A

Bicarbonate (HCO3)

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17
Q

What do the kidneys do when there is an alkaline pH in the blood?

A

Excrete Bicarbonate (HCO3) into urine

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18
Q

The more acidic the pH what do they kidneys do?

A

Keep Bicarbonate (HCO3) which is a base and helps balance

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19
Q

What is the time frame of the Renal buffer system?

A

Hours to days

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20
Q

What is the time frame of the Respiratory Buffer system vs the Renal Buffer system?

A

Resp: 1-3 minutes; Renal: hours to days

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21
Q

Acidosis is when the pH is lower than what?

A

7.35

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22
Q

Alkalosis is defined as a pH above what?

A

7.45

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23
Q

What are the two measures of Respiratory Acidosis?

A

pH less than 7.35 and PaCO2 greater than 45mmHg

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24
Q

What are the two measures of Respiratory Alkalosis?

A

pH greater than 7.45 and PaCO2 less than 35mmHg

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25
Q

Accumulated CO2 combines with water and forms what?

A

Carbonic Acid (H2CO3) which lowers pH

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26
Q

Respiratory Acidosis is due to an accumulation of what?

A

CO2, which combines with water and forms Carbonic Acid (H2CO3) and lowers pH

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27
Q

What type of breathing can cause Respiratory Acidosis?

A

Hypoventilation

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28
Q

Hypoventilation can cause a build up of what?

A

CO2, which combines with water to make Carbonic Acid (H2CO3) and lowers pH

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29
Q

What type of breathing can result in Respiratory Alkolosis?

A

Hyperventilation

30
Q

Hyperventilation can lead to what?

A

Respiratory Alkolosis

31
Q

What are the two measures for Metabolic Acidosis?

A

pH less than 7.35 and Bicarbonate (HCO3) less than 22

32
Q

Metabolic Acidosis is caused by a deficit of ____ or an excess of ___

A

Deficit of base; excess of acid other than CO2

33
Q

Which compound does Metabolic Acidosis not take into account?

A

CO2

34
Q

What can cause a deficit of base leading to Metabolic Acidosis?

A

Diarrhea, intestinal fistulas

35
Q

Metabolic Alkolosis is measured by which two values?

A

pH greater than 7.45 and Bicarbonate (HCO3) greater than 26

36
Q

Metabolic Alkolosis can be caused by what two things?

A

Too much base (too much antacid) or loss of acid (puking, diuretics)

37
Q

What is PaCO2?

A

Partial Pressure of Carbon Dioxide that is dissolved

38
Q

What is a normal PaCO2 range?

A

35-45

39
Q

A PaCO2 greater than 45 means what for the pH?

A

Acidosis

40
Q

A PaCO2 greater than 35 means what for the pH?

A

Alkolsis

41
Q

What is PaO2?

A

Partial Pressure of Oxygen that is dissolved

42
Q

What is the normal PaO2 range?

A

80-100 mmHg

43
Q

What is HCO3?

A

Bicarbonate.

44
Q

What is the normal HCO3 (bicarbonate) range?

A

22-26 mEq/L

45
Q

HCO3 (bicarbonate) greater than 27 means what?

A

Alkalosis

46
Q

HCO3 (bicarbonate) less than 21 means what?

A

Acidosis

47
Q

What is SaO2?

A

Arterial Oxygen saturation

48
Q

What is a normal Sa02 range?

A

95-100%

49
Q

An ABG with the following values means what? pH=7.49, PaCO2=43, HCO3=32

A

pH is high (alkalotic), PaCO2 is slightly high (acidotic), HCO3 is high (alkalotic). Metabolic Alkalosis. The PaCO2 is rising in an attempt to compensate the alkaline environment as CO2 is acidic.

50
Q

If pH and HCO3 are both high is this Respiratory or Metabolic Alkalosis?

A

Metabolic Alkalosis. HCO3 is controlled by kidneys so an evelated Bicarbonate means the metabolic system (aka kidneys) is involved

51
Q

If pH and HCO3 are both low is this Respiratory or Metabolic Acidosis?

A

Metabolic Acidosis. HCO3 is controlled by kidneys. When HCO3 (Bicarbonate) is low and pH is low you have Metabolic Acidosis.

52
Q

What are the basic steps in interpreting an ABG?

A

1 check pH for acidic/basic/normal. 2 check PaCO2 for acidic/basic/normal. 3 check HCO3 for acidic/basic/normal. If pH and CO2 are opposite one another but HCO3 is normal then Respiratory. If pH and HCO3 are both high or low then Metabolic.

53
Q

If pH and CO2 are opposite then the the issue is Respiratory or Metabolic?

A

Respiratory

54
Q

If pH and HCO3 are both high or both low then the issue is Respiratory or Metabolic?

A

Metabolic.

55
Q

What is “compensation”?

A

When CO2 tries to compensate for Metabolic Acidosis or Metabolic Alkalosis.

56
Q

If pH is 7.8 and HCO3 is 32 is this respiratory or metabolic alkalosis? If CO2 is 45 what is happening?

A

Metabolic Alkalosis. Elevated CO2 increased acidity and “compensates” for alkalosis.

57
Q

An elevated CO2 in the presence of very high pH and HCO3 means what?

A

Metabolic Alkalosis with compensation

58
Q

Low pH and low HCO3 means what?

A

Metabolic Acidosis

59
Q

Low pH, high CO2, and normal HCO3 means?

A

Respiratory Acidosis

60
Q

High pH, low CO2, and normal HCO3 means?

A

Respiratory Alkalosis

61
Q

Low pH, normal CO2, low HCO3 means?

A

Metabolic Acidosis without compensation

62
Q

Would the CO2 be high or low during compensation during Metabolic Acidosis

A

Low CO2

63
Q

Would the CO2 be high or low during compensation during Metabolic Alkalosis

A

CO2 would be high

64
Q

pH 7.33, pCO2 60, HCO3 34

A

Resp Acidosis with metabolic compensation.

65
Q

pH 7.48, pCO2 42, HCO3 30

A

Metabolic Acidosis with no CO2 compensation

66
Q

pH 7.38, pCO2 38, HCO3 24

A

Normal

67
Q

pH 7.21, pCO2 60, HCO3 24

A

Resp Acidosis with no metabolic compensation

68
Q

pH 7.48, pCO2 28, HCO3 20

A

Respiratory Alkalosis with metabolic compensation

69
Q

pH 7.50, pCO2 29, HCO3 24

A

Respiratory Alkalosis with no metabolic compensation

70
Q

pH 7.28, pCO2 40, HCO3 18

A

Metabolic Acidosis with no CO2 compensation

71
Q

pH 7.45, pCO2 26, HCO3 16

A

Respiratory Alkalosis with metabolic compensation

Diagnostic Methods - Medical Lab (6 decks)

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