Acid-Base Balance

Question 1

Respiratory imbalances affect:

Answer 1

carbonic acid concentration

Question 2

Metabolic imbalances affect:

Answer 2

base bicarbonate

Question 3

Acidosis can be caused by:

Answer 3

Increase in carbonic acid - respiratory acidosis
Decrease in bicarbonate - metabolic acidosis

Question 4

Alkalosis can be caused by:

Answer 4

Decrease in carbonic acid - respiratory alkalosis
Increase in bicarbonate - metabolic alkalosis

Question 5

Respiratory Acidosis is:

Answer 5

Carbonic acid excess

Question 6

Respiratory acidosis occurs with:

Explain further

Answer 6

Hypoventilation

Hypoventilation results in a buildup of CO2; subsequently, carbonic acid accumulates in the blood.

Carbonic acid dissociates, causing liberation of H-, and pH decreases.
If CO2 is not eliminated from the blood, acidosis results from the accumulation of carbonic acid.

Question 7

Respiratory alkalosis occurs with:

Explain further

Answer 7

Hyperventilation

The decrease in arterial CO2 levels leads to a decrease in carbonic acid concentration in the blood and an increase in pH.

Hyperventilation can occur as a physiological response to metabolic acidosis and increased metabolic demands (e.g. in a state of fever)

Question 8

Respiratory alkalosis is:

Answer 8

Carbonic acid deficit

Question 9

The primary cause of respiratory alkalosis

Answer 9

Hypoxemia from acute pulmonary disorders

Question 10

Metabolic acidosis is:

Answer 10

Base bicarbonate deficit

Question 11

Metabolic acidosis occurs when:

Answer 11

Acids other than carbonic acid accumulate in the body (e.g. ketoacid, lactic acid)

OR

When bicarbonate is lost from body fluids. (e.g. diarrhea, kidneys can’t reabsorb bicarbonate)

Question 12

Metabolic Alkalosis is:

Answer 12

Base bicarbonate excess

Question 13

Metabolic Alkalosis occurs when:

Answer 13

Occurs when acid is lost (as a result of prolonged vomiting or gastric suction)

Or

When bicarbonate increases (from ingestion of baking soda) occurs.

Question 14

Mnemonic ROME for ABG Values

Answer 14

R - Respiratory
O - Opposite
M - Metabolic
e - Equal

Question 15

In respiratory conditions, the pH and the PaCO2 are:

Answer 15

In opposite directions (RO)

In respiratory alkalosis, the pH is ↑ and the PaCo2 is ↓

In respiratory acidosis, the pH is ↓ and the PaCo2 is ↑

Question 16

In metabolic conditions, the pH and the HCO3- go:

Answer 16

In the same direction (ME)

In metabolic alkalosis, the pH and HCO3- are ↑

In metabolic acidosis, the pH and HCO3- are ↑

Question 17

Values for pH

Answer 17

Acidosis - < 7.35
Normal - 7.35 - 7.45
Alkalosis - > 7.45

Question 18

Values for CO2

Answer 18

Acidosis - > 45 mmHg
Normal - 35-45 mmHg
Alkalosis - < 35 mmHg

Question 19

Values for HCO3-

Answer 19

Acidosis - < 22 mEq/L
Normal - 22-26 mEq/L
Alkalosis - >26 mEq/L