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Respiratory 1 > Acid-Base Balance > Flashcards

Acid-Base Balance Flashcards

1
Q

What chemicals constitute the primary pH buffer system in the blood?

A

Bicarbonate and CO2

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2
Q

Normal pH of the blood

A

7.4 (7.35-7.45)

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3
Q

Organs that are largely responsible for pH control

A

Lungs (through PCO2)

Kidneys (through HCO3-)

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4
Q

donate protons

A

Acid

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5
Q

accept protons

A

Base

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6
Q

Acid/base that dissociates completely

A

Strong acid/base

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7
Q

Acid/base that dissociates partially (results in conjugate bases/acids)

A

Weak acid/base

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8
Q

a solution that resists pH changes when an acid or base is added

A

Buffer

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9
Q

Metabolic acids (acids other than carbonic acid) are eliminated via the ______

A

Kidneys

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10
Q

What are the two types of acid that are eliminated by the lung and kidney, respectively?

A

Lung eliminates respiratory acid = CO2

Kidney eliminates metabolic acid = end products of protein, AA, and nucleic acid metabolism

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11
Q

Normal concentration of bicarbonate in blood

A

24 (24-28 mEq/L)

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12
Q

Why is it beneficial to have our buffer system in an “open” environment

A

If our blood becomes acidic and shifts to producing CO2 from bicarbonate, the CO2 can be blown off in the lungs, allowing for minimal impact from the acid on our pH

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13
Q

Why is bicarbonate a good biological buffer?

A
  1. Abundant (24-28 mEq/L)
  2. Good in an open system (lungs)
  3. PCO2 and HCO3- can be regulated independently
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14
Q

Examples of other buffers in body besides bicarbonate

A
  1. Plasma proteins and intracellular proteins w/ acidic and basic residues
  2. Hb (rich in Histamine)
  3. Non-protein buffers
  4. movement of acids and bases between plasma and cells
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15
Q

Normal cell (cytosolic) pH

A

6.8

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16
Q

How do the kidneys respond to excess acid?

A

Elimination of acid in urine

Retention of bicarbonate

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17
Q

Buildup of CO2 due to insufficient excretion of CO2 by the lungs; pH falls and PaCO2 rises; Caused by hypoventilation; can be caused by alcohol, drugs, or neuromuscular insult

A

Respiratory acidosis

18
Q

Excess excretion of CO2 due to hyperventilation; pH rises and PaCO2 falls; can be caused by anxiety, drugs, acute asthma and neural dysregulation

A

Respiratory alkalosis

19
Q

Buildup of acids (such as lactic or keto acids) to plasma that consume bicarbonate; CO2 stays normal as lungs compensate; can be caused by hypoxia, exercise, diabetes, diarrhea or renal syndromes

A

Metabolic acidosis

20
Q

Loss of acids (such as lactic or keto acids), resulting in increased plasma bicarbonate; CO2 stays normal as lungs compensate; can be caused by emesis (loss of HCl), diuretics or excess ingestion of bicarbonate

A

Metabolic alkalosis

21
Q

Compensation for respiratory acidosis

A

Renal compensation by increasing secretion of H+ in urine and retaining bicarbonate in plasma

22
Q

Compensation for respiratory alkalosis

A

Renal compensation by decreasing secretion of H+ in urine and decreasing retention of bicarbonate in plasma

23
Q

Compensation for metabolic acidosis

A

Inc. ventilation to decrease CO2 to normalize pH (can progress to Kussmaul breathing)

24
Q

What is the breathing that is first rapid and shallow but progresses to deep labored breathing in severe diabetic keto acidosis?

A

Kussmaul breathing

25
Q

Compensation for metabolic alkalosis

A

Dec. ventilation to inc. CO2 (rarely happens since it can cause hypoxemia)

26
Q

metabolic pH disturbances have compensation at the level of what organ system?

A

respiratory (lungs and rate of ventilation)

27
Q

respiratory pH disturbances have compensation at the level of what organ system?

A

renal (kidneys and selective retention/excretion)

  • much slower than respiratory!!
28
Q

Equation for the Anion Gap

A

Anion gap= Na - (Cl + HCO3-)

29
Q

Normal range of carbon dioxide in blood

A

40 for convention (35-45)

30
Q

Compensation Equation for metabolic acidosis (low HCO3)

A

PaCO2= (1.5 x HCO3) + (8+-2)

31
Q

Indication for mechanical ventilation (invasive positive pressure)

A

Hyoxemic respiratory failure
Hypercarbic respiratory failure
Unstable airway (coma or seizure)

32
Q

Goals of mechanical/invasive ventilation

A

Adequate tidal volume, respiratory rate and oxygen concentration
Prevent alveolar collapse (PEEP)

33
Q

PEEP

A

Positive End Expiratory Pressure

34
Q

Goals for mechanical ventilation in a case of hypoxemia

A

Adjust oxygen concentration and PEEP

35
Q

Goals for mechanical ventilation in a case of hypercarbia

A

Inc. minute ventilation (tidal volume and respiratory rate)

BiPAP (inc. inspiratory pressure to inc. TV)

36
Q

Respiratory acid is aka

37
Q

Metabolic acid is aka

A

non-volatile or fixed

38
Q

What diagram is used to interpret acid-base disturbances?

A

Davenport diagram

  • Be able to read and interpret the diagram!!
39
Q

Davenport diagram shows relationship between plasma

A

pH, HCO3-, and PCO2

40
Q

True or False: Respiratory compensation takes longer than renal (metabolic) compensation

Respiratory 1 (11 decks)

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