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Respiratory > Acid-base balance > Flashcards

Acid-base balance Flashcards

1
Q

What is being regulated in acid-base balance?

A

The hydrogen ion concentration [H+]

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2
Q

How does the body get rid of H+?

A

Most, or all, of the H+ is excreted in urine

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3
Q

What do hydrogen ions react with to form carbonic acid?

A

Bicarbonate

H+ + HCO3- –> H2CO3

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4
Q

What is carbonic acid removed as?

A

Carbon dioxide and water

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5
Q

What are the 2 acid-base problems that can arise in the body?

A
  1. Too much H+

2. Too much CO2

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6
Q

Explain compensation

A

The body will try and restore the concentrations back to normal by compensation. If there is too much H+ the body will blow off CO2. If there is too much CO2 the kidney will excrete more H+.

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7
Q

Define acidaemia

A

Increased [H+]

pH < 7.35

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8
Q

Define alkalaemia

A

Decreased [H+]

pH > 7.45

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9
Q

Define acidosis

A

The process tending to cause increased [H+]

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10
Q

Define alkalosis

A

The process tending to cause decreased [H+]

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11
Q

What is the primary change if it is respiratory?

A

The primary change is in the pCO2

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12
Q

What is the primary change if it is metabolic?

A

The primary change is in the HCO3-

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13
Q

Define respiratory acidosis

A

Increased [H+] due to an increased pCO2

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14
Q

Define respiratory alkalosis

A

Decreased [H+] due to a decreased pCO2

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15
Q

Define metabolic acidosis

A

Increased [H+] due to decreased HCO3-

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16
Q

Define metabolic alkalosis

A

Decreased [H+] due to increased HCO3-

17
Q

What is the primary problem in metabolic acidosis and how is it compensated for?

A

Too much H+

Respiratory compensation - CO2 is blown off (reduces the pCO2)

18
Q

What is the primary problem in respiratory acidosis and how is it compensated for?

A

Too much CO2

Metabolic compensation - excrete more H+

19
Q

What are the 4 arterial blood gases?

A

H+, pCO2, HCO3-, pO2

20
Q

Give 3 causes of respiratory acidosis

A

Choking
Bronchopneumonia
COPD

21
Q

Give 3 causes of respiratory alkalosis

A

Hysterical over breathing
Mechanical over-ventilation
Raised intracranial pressure – potentially impact on the respiratory centre in the brain

22
Q

Give 3 causes of metabolic acidosis

A

Impaired H+ excretion
Increased H+ production or ingestion
Loss of HCO3-

23
Q

Give 3 causes of metabolic alkalosis

A

Loss of H+ in vomit
Alkali ingestion
Potassium deficiency

24
Q

What is the equation for oxygen delivery?

A

DO2 = CO x [(1.3 x Hb x SaO2) + 0.003 x PaO2]

cardiac output x arterial oxygen concentration

25
Q

What are 4 causes of tissues hypoxia?

A

Anaemic hypoxia
Perfusional hypoxia
Toxic hypoxia
Hypoxaemic hypoxia

26
Q

What is FiO2?

A

FiO2 is the fraction of inspired oxygen. In other words, what percentage of the air being inspired is oxygen.

27
Q

What range of saturation should you keep a patient with a chronic condition?

A

SaO2 88-92%

28
Q

What range of saturation should most patients be kept in?

A

SaO2 94-98%

29
Q

Give 4 buffers for H+ in the body

A

Haemoglobin
Bicarbonate
Potassium
Ammonium

30
Q

What is the clinical term for uncompensated respiratory acidosis?

A

Acute Type II respiratory failure

31
Q

What is the clinical term for compensated respiratory acidosis?

A

Chronic Type II respiratory failure

32
Q

What is the clinical term for decompensated respiratory acidosis?

A

Acute on chronic respiratory acidosis

33
Q

What is the anion gap?

A

The difference between the positively charged (cations) and the negatively charged (anions) in serum, plasma or urine. Values show the number of extra positive things.

34
Q

How is the anion gap calculated?

A

Calculated by subtracting the serum concentration of chloride and bicarbonate (anions) from the concentration of sodium and potassium (cations)
-Na+ + K+ = Cl- + HCO3-

35
Q

What does a higher than normal anion gap show?

A

Metabolic acidosis

36
Q

What are the causes of a high anion gap?

A

AMUDPILES

Alcohol, methanol, uraemia, DKA, paraquat, infection, lactic acid, ethylene glycol and salicylates

37
Q

What is base excess?

A

The amount of strong acid required to bring the pH back to 7.4, when CO2 is corrected to 5.3 (normal BE is between 2 and -2)

38
Q

What is base excess used to diagnose?

A

Metabolic acidosis and alkalosis
BE > +2 = metabolic alkalosis
BE < -2 = metabolic acidosis

Respiratory (12 decks)

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