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Respiratory > ABGs > Flashcards

ABGs Flashcards

1
Q

Which of the two systems is the most powerful compensator of metabolic inbalances?

A

Metabolic

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2
Q

What is the normal pH range?

A

7.35-7.45

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3
Q

At what level does the optimal level of acid/base dissociation occur?

A

K

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4
Q

Why is the bicarbonate the main buffer system in the body?

A

There is dual control via volatile gas (CO2) and renal control of bicarb and H+

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5
Q

Name 5 other buffers in the body

NB - 3 main categories

A

BBS, Hb, intracellular protein, plasma proteins, phosphate,

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6
Q

What is the Henderson-Hasselback equation?

A

pH = pKa (6.37) + logHCO3-/0.03xpCO2

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7
Q

How do you work out HCO3 levels?

A

Derive from HH equation, you can’t get it from the ABG directly.

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8
Q

What is the base excess?

A

amount of moles os stron acid required to back titrate 1 litre of blood to correct pH….finish…

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9
Q

Normal pCO2 levels?

A

4.5 - 5.8kPa

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10
Q

Normal pO2 levels?

A

11-13 kPa

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11
Q

Normaly HCO3- levels

A

22-28

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12
Q

Normal base excess?

A

-2 to +2 mmol/L

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13
Q

Normal anion gap?

A

10-14

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14
Q

Normal chloride levels?

A

98-107

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15
Q

Name 2 potential causes of a primary respiratory alkalosis?

A

PE, pneumonia

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16
Q

What are normal Na+ levels?

A

135-145

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17
Q

What is main cause of primary metabolic alkalosis?

A

Loss of acid in vomiting

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18
Q

What is the anion gap? And which anions are the cause of it?

A

The unmeasured anion gap
(because blood tests measure most cations but only a few anions)
Na+ - (Cl- + HCO3-)
The unmeasured anions are intracellular (and??)

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19
Q

How do you correct the anion gap for albumin?

A

Corrected AG = AG + [0.25 x (40 - [alb])]

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20
Q

CAUSES of high AG metabolic acidosis

A

…

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21
Q

Normal causes normal AG metabolic acidosis

A

….

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22
Q

When would you look at the anion gap?

A

If the patient is acidotic but CO2 seems to be normal ?

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23
Q

Why does someone who is bicarb wasting have a normal anion gap?

A

Bicarb wasting

24
Q

How long does respiratory compensation take?

A

Begin in minutes, complete in 12-24 hours

25
Q

What are the two components of metabolic acidosis?

A

Cellular and renal

26
Q

How long does cellular compensation take?

A

Minutes to hours

27
Q

How long does renal compensate take?

A

3-5 days

28
Q

What is the alveolar-arterial gradient?

A

The difference between the calculated pO2 and the measured arterial pO2.

29
Q

What is arterial pO2?

A

Function of ventilation and fractional inspired concentration of O2 (FiO2)

30
Q

What is the A-a gradient affected by? (3)

A

Altitude
Inspired oxygen percentage
Rate of respiration

31
Q

What are the causes of hypoxia with a normal A-a gradient?

A

Hypoventilation

Subnormal PiO2

32
Q

What are the causes of hypoxia with a raised A-a gradient?

A

V/Q mismatch
Shunt
Dead space
Low cardiac output states

33
Q

Why can’t a shunt be corrected with 100% oxygen?

A

The alveoli units are STILL not being perfused. The same fraction of deoxygenated blood continues to circulate the system.

34
Q

What is carpo-pedal spasm?

2 signs?

A

….??

Acutely hypocalcaemic signs due to increasingly negative charge due to hypocapnia

35
Q

Why is breathing into a paper bag helpful for those hyperventilating?

A

They rebreathe their own CO2, reduces their hypocapnia

36
Q

When should you be considering A-a gradient?

A

Hypoxia

37
Q

What is the most common ECG finding for a PE?

A

Sinus tachycardia

38
Q

What are normal potassium levels?

A

3.5-5 mmol/L

39
Q

Normal creatinine levels?

A

70 - 150 micromol/L

40
Q

Normal urea levels?

A

2.5 - 6.7 mmol/L

41
Q

Normal eGFR?

A

> 90

42
Q

What are the biggest risks when plasma electrolytes are dangerously abnormal?
(2 main categories)

A 
Cardiac arrhythmias
CNS events (eg seizures)
43
Q

When should you be REALLY worried about Na+ levels?

A

155 mmol/L

44
Q

When should you be REALLY worried about K+ levels?

A

6.5 mmol/L

45
Q

When should you be REALLY worried about Ca+ levels? (corrected)

A

3.5 mmol/L

46
Q

When should you be REALLY worried about glucose levels?

A

20 mmol/L

47
Q

When is hypoxia severe?

A

<8.0kPa

48
Q

When is pH dangerously acidotic?

A

<7.1

49
Q

When are haemoglobin levels dangerously low?

A

<70g/l

50
Q

When are platelets dangerously low?

A

< 40x10^9/L

51
Q

What concentration of neutrophils would you expect in meningitis?

A

> 1 neutrophil/ mm^3

52
Q

What biochemical features would you find in dehydration? (3)

And two other features of patient?

A 
Incr urea (moreso than creatinine)
Incr albumin
Incr haemocrit
Decr urine volume
Decr skin turgor
53
Q

What are the two major biochemical pictures of abnormal kidney function?

A

Low GFR

Tubular dysfunction

54
Q

How does low GFR appear biochemically?

A 
Incr urea
Incr creatine
Incr K+
Incr H+
Incr urate
Incr phosphate
Incr anion gap

Mem aid
CHUK A PU (up)

Decr
Bicarbonate, urine output (oligouria)

55
Q

What are the causes of low GFR?

A

Early acute oliguric renal failure

Chronic kidney disease

56
Q

If low GFR is caused by chronic kidney disease, what else is found biochemically?

A

Decr Hb
Incr PTH
Renal bone disease

Respiratory (11 decks)

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