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Patho Exam 3 > Acid-Base > Flashcards

Acid-Base Flashcards

1
Q

Relative excess of any acid except carbonic acid

A

Metabolic Acidosis

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2
Q

May be caused by:
Increase in acid
Excess removal or decrease in base
Combination of increase in acid and decrease in base

A

Metabolic Acidosis

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3
Q

Decreases the normal ratio of bicarbonate to carbonic acid because the bicarbonate is used up in buffering excess acid______

A

Metabolic acidosis

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4
Q

Caloric and glucose intake is insufficient
Body begins to use fat stores for energy
Fat metabolizes incompletely
This is __________, a type of ______

A

starvation ketoacidosis; metabolic acidosis

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5
Q

Ketoacids accumulate in blood, causing metabolic acidosis

A

starvation ketoacidosis

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6
Q

diabetes mellitus, starvation, alcoholism are just some symptoms of _____

A

ketoacidosis

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7
Q

Severe hyperthyroidism
Burns
Circulatory shock
due to ______

A

increase in acid

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8
Q

Tissue anoxia
Oliguric renal failure
due to ______

A

increase in acid

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9
Q

Anything that causes a removal/decrease in bicarbonate

due to ______

A

decrease/removal of base

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10
Q

Diarrhea: loss of intestinal fluid that is rich in bicarbonate ions that originate from pancreatic secretions
Gastrointestinal fistula that drains intestinal or pancreatic secretions; intestinal decompression
Renal tubular acidosis
have in common that __________

A

they include the excessive removal of/decrease in base

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11
Q

Headache
Abdominal pain
Central nervous system depression
symptoms of _______

A

metabolic acidosis

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12
Q 
Confusion
Lethargy
Stupor
Coma
result from \_\_\_\_\_\_\_\_ system depression in \_\_\_\_\_\_\_
A

central nervous; metabolic acidosis

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13
Q

Tachycardia
Ventricular dysrhythmias (from myocardial intracellular acidity)
Decreased cardiac contractility
result from __________

A

severe metabolic acidosis

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14
Q

Death from brainstem dysfunction usually occurs if pH falls below 6.9 in _______

A

severe metabolic acidosis

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15
Q

In metabolic acidosis, uncompensated ABG symptoms include
_____bicarbonate concentration
pH _____
_____ Paco2

A

decreased; decreased; normal

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16
Q

Hyperventilation is typical respiratory compensatory response in ______

A

metabolic acidosis

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17
Q

Low blood pH stimulates peripheral chemoreceptors
Ventilatory neurons respond to increase rate and depth of respiration
are compensatory responses of _______

A

metabolic acidosis

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18
Q

Results in increased excretion by lungs of carbonic acid (CO2 + water)
a typical compensatory response of ________

A

metabolic acidosis

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19
Q

Does not remove metabolic acids from body

a compensatory response of ______

A

metabolic acidosis

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20
Q

Does change ratio of bicarbonate ions to carbonic acid
Results in compensatory increase in pH
compensatory response of ________

A

metabolic acidosis

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21
Q

In compensated metabolic acidosis, show:
_______ bicarbonate concentration (primary disorder)
______-PaCO2 (compensation)
______ or even normal pH, depending on the degree of compensation

A

decreased; decreased; decreased

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22
Q

Which of the following would be associated with metabolic acidosis?

Central nervous system depression
Increased serum bicarbonate level
Prolonged vomiting or gastric suctioning
pH greater than 7.40

A

Central nervous system depression

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23
Q

Any condition that causes an excess of carbonic acid

A

Respiratory Acidosis

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24
Q

Caused by impaired removal of carbonic acid by the lungs

A

Respiratory Acidosis

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25
Q

Impaired gas exchange
Inadequate neuromuscular function
Impairment of respiratory control in the brainstem

symptoms of impaired removal of ________ from lungs

A

carbonic acid

26
Q

Decrease the normal 20:1 ratio of bicarbonate ion to carbonic acid

A

carbonic acid

27
Q

Chronic obstructive pulmonary disease (COPD)
Pneumonia
Severe asthma

symptoms of _______-

A

respiratory acidosis

28
Q

Pulmonary edema
Acute (adult) respiratory distress syndrome
symptoms of _________

A

respiratory acidosis

29
Q

Guillain-Barré syndrome
Chest injury or surgery (pain limits breathing)
symptoms of ________-

A

respiratory acidosis

30
Q

Hypokalemic respiratory muscle weakness
Severe kyphoscoliosis
Respiratory muscle fatigue
symptoms of ________

A

respiratory acidosis

31
Q

Respiratory-depressants drugs (opioids, barbiturates)

cause impaired respiratory control in _________

A

respiratory acidosis

32
Q 
Headache
Tachycardia
Cardiac dysrhythmias
Neurologic abnormalities
Blurred vision, tremors, vertigo, disorientation, lethargy, somnolence
symptoms of \_\_\_\_\_\_\_
A

respiratory acidosis

33
Q

Peripheral vasodilation with hypotension

a HALLMARK of _______

A

SEVERE respiratory acidosis

34
Q

In respiratory acidosis
PaCO2 _____
pH ______
Bicarbonate _____

A

increased; decreased; normal

35
Q

Compensatory Responses in respiratory acidosis include:

_______renal excretion of metabolic acid (kidneys cannot excrete carbonic acid; this is solely a _____function)
Excretion of H+ and retention of HCO3−
Results in _____ of bicarbonate ion movement of pH toward ____
Requires several days to be effective

A

increased; respiratory; increase; normal

36
Q

In compensated respiratory acidosis, show:

______ PaCO2 (primary imbalance)
____ bicarbonate concentration (compensation)
______ or even normal pH, depending on degree of compensation

A

increased; increased; decreased

37
Q

A blood gas report shows the following: pH 7.30, PaCO2 51 mm Hg, and HCO3– 23 mEq/L. Which of the following conditions could produce these results?

Psychological distress
Pulmonary edema
Prolonged vomiting
Renal failure

A

pulmonary edema (uncompensated respiratory acidosis)

REMEMBER: decreased pH, increased PaCO2, normal bicarbonate

38
Q

What is the primary imbalance in respiratory acidosis?

A

PaCO2

39
Q

Any condition that tends to cause a relative deficit of any acid (except carbonic acid)

A

Metabolic Alkalosis

40
Q

Causes of metabolic acid

____ in base (bicarbonate)
_____in acid
_____ of the two

A

increase; decrease; combination

41
Q

Intake of bicarbonate or bicarbonate precursors (acetate, citrate, lactate)
causes increase in _______ in _______

A

base; metabolic alkalosis

42
Q

Massive transfusion with citrated blood
Mild or moderate extracellular fluid volume deficit
causes an increase in ________ in _______

A

base; metabolic alkalosis

43
Q

Emesis
Gastric suction
Mild or moderate extracellular fluid volume deficit
causes a decrease in _______ in _______

A

acid; metabolic alkalosis

44
Q

Hyperaldosteronism
Hypokalemia
cause a decrease in _______ in _______

A

acid; metabolic alkalosis

45
Q

*Postural hypotension
*Hypokalemia may coexist
Bilateral muscle weakness
Potassium shifts into cells
symptoms of _______

A

metabolic alkalosis

46
Q

Increased neuromuscular excitability
“Tingly” fingers and toes
Signs of tetany; may progress to seizures
Ionized hypocalcemia (calcium binds to albumin) contributes to the excitability
symptoms of _________

A

metabolic alkalosis

47
Q

Increased excitability of nerve cell membranes
Belligerence
symptoms of ______

A

metabolic alkalosis

48
Q

Central nervous system depression: confusion, lethargy, coma
Death usually occurs if pH rises to 7.8
symptoms of _______

A

severe metabolic alkalosis

49
Q

In metabolic alkalosis

Bicarbonate concentration ______
PaCO2 ______
pH ______

A

elevated; normal; above normal

50
Q

Compensatory Responses:
Hypoventilation
Usually incomplete

A

metabolic alkalosis

51
Q

In compensated metabolic alkalosis, show:

_____ bicarbonate concentration (primary imbalance)
______ PaCO2 (compensation)
Slightly _______pH

A

increased; increased; increased

52
Q

What’s responsible for the primary imbalance in metabolic alkalosis?

A

bicarbonate

53
Q

Any condition that tends to cause a carbonic acid deficit_______. Usually caused by ______

A

respiratory alkalosis; hyperventilation

54
Q 
Hypoxemia
Acute pain
Anxiety, psychological distress
Prolonged sobbing
Alcohol withdrawal
 symptoms of \_\_\_\_\_\_ in \_\_\_\_\_\_\_
A

hyperventilation; respiratory alkalosis

55
Q

Stimulation of the brainstem (salicylate overdose, meningitis, head injury, gram-negative sepsis)
symptom of ______ in _______

A

hyperventilation; respiratory alkalosis

56
Q

Increased neuromuscular excitability
Paresthesias (numbness and tingling) of fingers and around mouth
Carpal and/or pedal spasm
Decreases ionized calcium, which contributes to the excitability

Increased central and peripheral membrane excitability

symptoms of ________

A

Respiratory Alkalosis

57
Q

I*ncreased pH of cerebrospinal and cerebral interstitial fluid alters brain cell function
Can cause confusion or excitation
*Cerebral vasoconstriction
symptoms of ________

A

Respiratory Alkalosis

58
Q

Uncompensated ABG in respiratory alkalosis leads to
PaCO2 to be abnormally ____
pH is abnormally ____
Bicarbonate ______

A

low; high; normal

59
Q

Compensatory responses in respiratory alkalosis include:

______renal excretion of metabolic acid
______ of H+ by the kidneys

______ in bicarbonate ion concentration
Kidneys _____HCO3−

A

decreased; retention; decrease; excrete

60
Q

Renal compensation tends to return the ratio of bicarbonate ions to carbonic acid, moving pH toward normal

Because this takes several days and because many causes are short-lived, may not be fully compensated

compensatory response of ________

A

respiratory alkalosis

61
Q

In compensated respiratory alkalosis, show:

_____ PaCO2 (primary imbalance)
______ bicarbonate concentration (compensation)
_______ (somewhat high) pH

A

decreased; decreased; increased

62
Q

Primary imbalance in respiratory alkalosis is _____

A

PaCO2

Patho Exam 3 (12 decks)

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