Acid-Base

Question 1

what are you assessing when you look at pH and PCO2?

Answer 1

ventilation

Question 2

What are you assessing when you look at PaO2 and SaO2?

Answer 2

oxygenation

Question 3

acidosis

Answer 3

low serum bicarbonate

Question 4

acidemia

Answer 4

serum pH <7.35

Question 5

alkalosis

Answer 5

high serum bicarbonate

Question 6

alkalemia

Answer 6

serum pH > 7.45

Question 7

What is the purpose of the oxyhemoglobin dissociation curve?

Answer 7

tool used to show the relationship between oxygen saturation and the PaO2

Question 8

What happens to shift the oxyhemoglobin dissociation curve to the left?

Answer 8

decreased H+, decreased CO2, decreased temp

Question 9

What happens to shift the oxyhemoglobin dissociation curve to the right?

Answer 9

increased H+, increased CO2, increased temp

Question 10

Hendersen-Hesselbach Equation

Answer 10

H2CO3 = H + HCO3 = H2O + CO2

Question 11

What do the kidneys remove in response to pH changes?

Answer 11

metabolic acids, bicarbonate, lactic acid, ketones, phosphoric acid

Question 12

Pneumonics for underlying causes of anion gap and non AG metabolic acidosis

Answer 12

AG- MUDPILES. Non AG- USED CAR

Question 13

anion gap calculation

Answer 13

( Na + K) - ( Cl + HCO3). Normal AG is 3-11

Question 14

what is ureteral-sigmoid diversion?

Answer 14

accumulate urine in intestine, reabsorb Cl / H20 in intestine, secrete bicarb in intestine

Question 15

winter’s formula

Answer 15

used to calculate respiratory compensation for metabolic acidosis. PCO2=1.5x ( HCO3 +8 )

Question 16

summer’s formula

Answer 16

used to calculate respiratory compensation for metabolic alkalosis. PCO2=0.7 ( HCO3+21)

Question 17

how do you calculate delta anion gap?

Answer 17

Anion Gap – ( normal Gap (12))

Question 18

how do you calculate delta bicarb?

Answer 18

Measured bicarbonate – normal bicarb

Question 19

how do you determine if there’s a triple ripple?

Answer 19

If delta AG > delta BC then there is also metabolic alkalosis. If delta AG < delta BC then non- AG acidosis is also present.

Question 20

what is posthypercapnic alkalosis?

Answer 20

rapid lowering of chronically elevated PCO2 (usually by mechanical ventilation) resulting in metabolic alkalosis. Raises the cerebral intracellur pH

Question 21

What is an important test you should perform before messing with radial artery?

Answer 21

Allen’s Test

Question 22

Symptoms of alkalosis

Answer 22

paresthesias, tetany, seizures

Question 23

What is contraction alkalosis?

Answer 23

Loss of large volumes of fluid. Contraction of extracellular volume around relatively constant quantity of bicarbonate

Question 24

Which of the following are causes of contraction alkalosis: IV loop diuretics, thiazides, vomiting, sweat losses in CF pts?

Answer 24

all are causes of contraction alkalosis

Question 25

what can cause renal H+ loss?

Answer 25

excess aldosterone

Question 26

At what urine chloride levels will respond to saline treatment?

Answer 26

levels that are < 10mEq/L

Question 27

How many units of blood are needed before you’re likely to see metabolic alkalosis due to the citrate that’s infused with the blood?

Answer 27

8 or more units of blood