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Unit 7: Physiology > Acid Base Balance > Flashcards

Acid Base Balance Flashcards

1
Q

What is the formula for [HCO3-] ?

A

0.03 PCO2 x 10 ^(pH-6.1)

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2
Q

What is the normal bicarbonate level in the blood, what is this set by?

A

[HCO3-] =24 mM

-set by the kidney

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3
Q

What is the normal pCO2, what is this set by?

A

pCO2= 40 mmHg

-this is set by the lung

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4
Q

What is a metabolic line on the davenport graph?

A

family of curves which relate bicarbonate concentration to pH at a series of fixed PCO2 concentrations

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5
Q

What is a respiratory line on the davenport graph?

A

a line which represents the effect of pulmonary ventilation on blood pH and bicarbonate levels

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6
Q

What is TCO2 equal to?

A

[CO2] + [H2CO3]+[HCO3]

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7
Q

When HB is greater in the blood, what happens?

A

more HCO3- is produced per change in pH

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8
Q

What are some causes of hypoventilation?

A
  1. COPD -emphysema, asthma
  2. narcotics and anesthesia
  3. airway obstruction or lung collapse
  4. muscular dystrophy or paralysis
  5. pneumonia or bronchitis
  6. severe pulmonary edema
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9
Q

What is the normal pH of the blood?

A

7.4

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10
Q

During hypoventilation, or hypercapnea, what occurs to the pH? the bicarbonate level?

A

pH decreases - respiratory acidosis

bicarbonate increases

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11
Q

What is renal compensation for respiratory acidosis? Why is this strange?

A

reabsorption of HCO3-, excretion of H+

  • so HCO3- is increased further to essentially raise the pH
  • pH can rise or fall when HCO3- is inc
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12
Q

What is the main factor pH is determined by?

A

proton concentration (NOT HCO3-)

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13
Q

What are some causes of hyperventilation or hypocapnea?

A
  1. ventilator set too high
  2. anxiety attack
  3. trauma to the respiratory center
  4. brain tumor
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14
Q

As pCO2 is dec in respiratory alkalosis, what happens to the pH and HCO3-?

A

pH increases

HCO3- Decreases

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15
Q

Respiratory acidosis or alkalosis results in decreased cerebral blood flow?

A

respiratory alkalosis results in lightheadness and inability to concentrate (hyperventilate)

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16
Q

What is the renal compensation for respiratory alkalosis?

A

decrease HCO3- reabsorption (decreasing concentration even further) to decrease pH

-also dec excretion of titrable acids - NH4Cl

17
Q

What are some examples of metabolic alkalosis causes that are responsive to saline infusion?

A
  1. vomiting and dehydration
  2. gastric tubes
  3. excess diuretics
18
Q

What is an example of a cause of metabolic alkalosis that is unresponsive to saline infusion?

A

hyperaldosteronism

19
Q

What is the renal response to metabolic alkalosis?

A

decrease reabsorption of HCO3-

ALKALOSIS always want to dec HCO3- absorption

20
Q

What is the only acid/base disorder which renal compensation can completely normalize blood pH for?

A

respiratory alkalosis

21
Q

Why do excess diuretics cause metabolic alkalosis?

A

-inc loss of NaCl and fluids
-inc RAA stimulation
-inc renal proton secretion
(aldosterone causes Na reabsorption, K secretion creating hypokalemia - so you want to reabsorb K, and have to get rid of H+ as a result)

22
Q

What happens to the pH and HCO3- levels in metabolic acidosis?

A

pH decreases, HCO3- decreases

23
Q

What is the formula for the anion gap, and what is a normal value?

A

=Na- (Cl+ Hco3) = 12+/-4

24
Q

In diabetes mellitus, during ketoacidosis, what happens to the anion gap?

A

it is increased

25
Q

What are some causes of metabolic acidosis?

A
  1. diabetic ketoacidosis
  2. lactic acid
  3. poisons
    - methanol
    - ethylene glycol
    - aspirin overdose

Hypercholeremia:

  1. severe diarrhea
  2. uremias
26
Q

What occurs during proximal renal tubular acidosis?

A

reabsorption of bicarbonate is decreased

-metabolic acidosis

27
Q

What happens during distal renal tubular acidosis?

A

acid secretion is decreased

-metabolic acidosis

28
Q

What is a base deficit?

A

amount of HCO3- that should be added to bring patient back to normal

actual [HCO3-]-24

Unit 7: Physiology (19 decks)

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