Acid Base

Question 1

Normally blood pH

Answer 1

narrow range (7.35-7.45)

Question 2

H+ is regulated sequentially by

Answer 2

1) Chemical Buffer system
2) Respiratory Center in the brainstem
3) Liver Oxidation of Strong Acids
4) Renal mechanisms – ultimate acid-base regulatory organs

Question 3

What ions/molecules bind H+ when it is in excess?

Answer 3

phosphate, protein, bicarbonate

Question 4

Respiratory center regulation of pH

Answer 4

short lived reaction: Plasma H+ increasing, metabolic acidosis→ deep breathing to expel more CO2. Plasma H+ decreasing, metabolic alkalosis→ results in slower, shallow breathing to expel CO2

Question 5

Liver Oxidation regulation of pH

Answer 5

Eliminates acid by lactate oxidation and gluconeogenesis (both consume H+)

Question 6

Renal mechanisms for pH regulation

Answer 6

delayed but long term/effective –> if acidic→ filter out H+ and reabsorb more bicarbonate

Question 7

components of an arterial blood gas

Answer 7

1) pH of the blood
2) partial pressure of oxygen
3) partial pressure of CO2
4) Bicarbonate
5) O2 concentration and O2 saturation

Question 8

Anion Gap

Answer 8

the difference between unmeasured plasma cations and anions that is used to distinguish different causes of Acidosis/Alkalosis

Question 9

Equation for Anion Gap

Answer 9

Normal AG = Na+ - (Cl- + HCO3-)

Question 10

Pregnancy corresponds to what Acid-Base Disorder?

Answer 10

Respiratory Alkalosis

Question 11

Vomitting corresponds to what Acid-Base Disorder?

Answer 11

Metabolic Alkalosis

Question 12

Diarrhea corresponds to what Acid-Base Disorder?

Answer 12

Metabolic Acidosis (non-gap)

Question 13

Cirrhosis corresponds to what Acid-Base Disorder?

Answer 13

Respiratory Alkalosis

Question 14

Respiratory alkalosis

Answer 14

pH: high
pCO2: low
HCO3: low
secondary to hyperventilation; increased expulsion of CO2, –> increase in blood pH (more basic).

Question 15

Respiratory acidosis

Answer 15

pH: low
pCO2: high
HCO3: high
decreased respirations lead to decrease in pH as CO2 accumulates.

Question 16

Metabolic alkalosis:

Answer 16

pH: high
pCO2: high
HCO3: high
the loss of hydrogen ions from the gastrointestinal tract or in the urine →high HCO3 concentration and pH. (Per lecture, “low urine chloride”).

Question 17

Metabolic acidosis

Answer 17

pH: low
pCO2: low
HCO3: low
serum bicarbonate concentration (ie: Diabetic Ketoacidosis or diarrhea)

Question 18

Mixed/compensatory

Answer 18

simultaneous presence of more than one acid-base disorder

Question 19

Normal AG

Answer 19

12 +/- 2

Question 20

Normal PCO2

Answer 20

40

Question 21

Normal HCO2 (bicarbonate)

Answer 21

24

Question 22

If pH is normal but serum HCO3 is low, this is indicative of?

Answer 22

Mixed acid-base disorder

Question 23

COPD corresponds to what Acid-Base Disorder?

Answer 23

Respiratory Acidosis