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RUSVM Clinical Pathology 2016 > Acid Base Balance > Flashcards

Acid Base Balance Flashcards

1
Q

Why is maintenance of pH important?

A

Protein structure

Metabolism and Enzymes

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2
Q

What determines pH?

A

pCO2
Addition or removal of acids (H+)
Strong ion movements
Serum proteins, phosphates, and other weak acids

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3
Q

What are the regulatory systems of blood pH?

A

Extracellular and intracellular buffers
Rate of alveolar ventilation
Renal excretion of H+

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4
Q

What is the reason for buffer systems?

A

Minimize the changes in H+

Prevent sudden changes in pH

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5
Q

What are the components of the buffer system?

A

Bicarbonate/carbonic acid

Non bicarbonate components: Hemoglobin, Plasma Proteins, others

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6
Q

What are venous samples used for?

A

Good for evaluating acid base status

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7
Q

What are arterial samples used for?

A

Evaluate pO2

Useful for evaluating cardiopulmonary function

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8
Q

What tube is Blood gas analysis collected in?

A

Green Top Tube with Heparin

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9
Q

TCO2

A

Bicarbonate

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10
Q

pCO2

A

Acid

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11
Q

pCO2

A

Respiratory

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12
Q

HCO3

A

Metabolic

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13
Q

Increase of pH

A

Alkalemia

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14
Q

Decrease of pH

A

Acidemia

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15
Q

What causes Respiratory Acidosis

A

Hypoventilation

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16
Q

What causes Respiratory Alkalosis?

A

Hyperventilation

17
Q

What causes Metabolic Acidosis?

A

Increased acid in the absence of increased pCO2

Decreased HCO3

18
Q

What causes Metabolic Alkalosis?

A

Decreased acid in the absence of decreased pCO2

Increased HCO3

19
Q

Measurement of TCO2

A

Estimate of plasma bicarbonate concentration

20
Q

Base Excess

A

Characterizes the overall metabolic acid-base status independent of the respiratory acid-base status

21
Q

Metabolic alkalosis

A

+ Base Excess

22
Q

Metabolic Acidosis

A
  • Base Excess
23
Q

What are the 4 primary acid base abnormalities?

A

Respiratory Acidosis
Metabolic Acidosis
Respiratory Alkalosis
Metabolic Alkalosis

24
Q

What is the body’s compensatory response to abnormal pH?

A

Opposite system, Opposite type

25
Q

What causes Hypoventilation

A

Anesthesia
Diffuse pulmonary disease
Intrathoracic lesions
CNS disease

26
Q

What is the compensation for Respiratory Acidosis?

A

Secondary Metabolic Alkalosis = Retention of HCO3

27
Q

What are the 2 way Metabolic Acidosis can happen?

A

Increase in acid

Decrease in base

28
Q

What causes High Anion Gap Acidosis?

A

Ketones
Lactate
Uremic Acids
Ethylene glycol

29
Q

What is the calculation for anion gap?

A

(Na + K) - (Cl+ HCO3)

30
Q

How is HCO3 lost?

A 
Diarrhea
Intestinal ileus
Salivation 
Urinary loss
Titration
31
Q

What is the short term compensation for Metabolic Acidosis?

A

Increased ventilation with decreased pCO2

32
Q

What is the long term compensation for Metabolic Acidosis?

A

Increased renal excretion of H+ with retention of HCO3

33
Q

What causes Hyperventilation?

A

Hypoxemia
Pain, Anxiety
Hyperthermia
Drugs that stimulate the medullary respiratory center

34
Q

What is the compensation for Respiratory Alkalosis?

A

Secondary Metabolic acidosis = renal retention of H+

35
Q

What is the 2 way Metabolic Alkalosis can happen?

A

Decreased Acid

Increased Base

36
Q

What are the causes of Hypochloremic Metabolic Alkalosis?

A

Severe vomiting, pyloric obstruction

Sequestration of fluid in abomasum and forestomaches

37
Q

What causes Excessive Renal loss of H+?

A

Diuretics

Increased mineralcorticoid activity (aldosterone)

38
Q

What is the short term compensation for metabolic alkalosis?

A

Decreased ventilation and increased pCO2

39
Q

What is the long term compensation for metabolic alkalosis?

A

Increased renal retention of H+ with decreased generation of HCO3

RUSVM Clinical Pathology 2016 (22 decks)

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