Acid-Base Disorders

Question 1

maintenance of pH is important for

Answer 1

protein structure

metabolism and enzymes

Question 2

T/F small changes in pH=large changes in [H+]

Answer 2

true

Question 3

pH is determined by

Answer 3

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

Question 4

regulatory systems

Answer 4

Extracellular and intracellular buffers

Rate of alveolar ventilation (pCO2)

Renal excretion of H+

Question 5

buffer systems

Answer 5

minimize the changes in [H+]

prevent sudden changes in pH

Question 6

components of the buffer system

Answer 6

Bicarbonate/carbonic acid

Non-bicarbonate components

• Hemoglobin
• Plasma proteins

Question 7

what happens when you add H+ to the system

Answer 7

H+ combines with HCO3- to form H2O + CO2 –> CO2 is exhaled (CO2 thought of as an acid, increases with increase in H+)

Question 8

venous blood samples

Answer 8

‒ Good for evaluating acid base status

‒ Useful in most clinical situations

Question 9

arterial blood samples

Answer 9

‒ Evaluates pO2

‒ Useful for evaluating cardiopulmonary function

Question 10

blood collection

Answer 10

Anaerobic: avoid exposure to air

Whole blood from a free flowing vessel –> heparin tube

Analyze ASAP (>15 min put on ice-ice-baby)

Question 11

what is TCO2

Answer 11

BICARB!!!!

Question 12

pCO2 represents

Answer 12

respiratory system

Question 13

TCO2 represents

Answer 13

metabolic system (BICARB!!)

Question 14

metabolic acidosis

Answer 14

↑ acid in the absence of ↑ pCO2

↓ base, ↓ HCO3-

Question 15

metabolic alkalosis

Answer 15

↓ acid in the absence of ↓ pCO2

↑ base, ↑ HCO3-

Question 16

T/F measurement of TCO2 is an estimate of bicarb

Answer 16

true

Question 17

T/F TCO2 is NOT a measurement of pCO2

Answer 17

TRUE!!!

Question 18

base excess: metabolic alkalosis

Answer 18

(+) BE

Question 19

base excess: metabolic acidosis

Answer 19

(-) BE

Question 20

what is base excess used to calculate

Answer 20

bicarb dosage in IVF

Question 21

What are the 4 Primary Acid Base Abnormalities

Answer 21

1. Respiratory acidosis
2. Metabolic acidosis
3. Respiratory alkalosis
4. Metabolic alkalosis

Question 22

compensation=

Answer 22

opposite system, opposite type

Question 23

TCO2 is ________; pCO2 is ________.

Answer 23

Bicarb; an acid

Question 24

respiratory acidosis

Answer 24

hypoventilation 
­- Anesthesia
­- Diffuse pulmonary disease
- Intrathoracic lesions
- CNS disease

Question 25

respiratory acidosis: compensation

Answer 25

Secondary metabolic alkalosis = retention of HCO3-

Question 26

2 ways metabolic acidosis can happen

Answer 26

↑ in acid or ↓ in base (diarrhea cha cha cha)

Question 27

High Anion Gap Acidosis (Metabolic acidosis)

Answer 27

Increase in nonvolatile acids (KLUE) Ketones ­Lactate Uremic acids (phosphates, sulfates) Ethylene glycol metabolites (toxins)

Question 28

at what value is anion gap considered a problem

Answer 28

>25

Question 29

what is anion gap based on

Answer 29

the principle of electroneutrality Used to detect unmeasured anions (KLUE)

Question 30

anion gap equation

Answer 30

AG = (Na+ + K+) − (Cl− + HCO3−)

Question 31

loss of HCO3-

Answer 31

‒ GI loss from diarrhea ‒ Intestinal ileus ‒ Salivation (ruminants) -- choke ‒ Urinary loss ‒ Titration

Question 32

short term metabolic acidosis compensation

Answer 32

secondary respiratory alkalosis --> ↑ ventilation with ↓ pCO2

Question 33

long term metabolic acidosis compensation

Answer 33

Increased renal excretion of H+ with retention of HCO3

Question 34

respiratory alkalosis

Answer 34

``` hyperventilation ­- Hypoxemia - Pain, anxiety, etc. - Hyperthermia - Drugs that stimulate the medullary respiratory center ```

Question 35

respiratory alkalosis compensation

Answer 35

Secondary metabolic acidosis = renal retention of H+

Question 36

2 ways metabolic alkalosis can happen

Answer 36

↓ in acid (vomitting) or ↑ in base

Question 37

hypochloremic metabolic alkalosis

Answer 37

Monogastrics: severe vomiting, pyloric outflow obstruction (GDV) ­Ruminants: sequestration of fluid in abomasum and forestomachs (LDA and RDA)

Question 38

hypochloremic metabolic alkalosis can result in

Answer 38

paradoxical aciduria

Question 39

what two things are required for paradoxical aciduria

Answer 39

hypochloremia volume depletion

Question 40

causes of excessive renal loss of H+

Answer 40

diuretics increased mineralocorticoid activity

Question 41

short term compensation for metabolic alkalosis

Answer 41

decreased ventilation=↑ PCO2

Question 42

long term compensation for metabolic alkalosis

Answer 42

Increased renal retention of H+ with decreased generation of HCO3-

Question 43

what are mixed disturbances

Answer 43

2 primary disturbances occurring simultaneously

Question 44

when do we suspect a mixed disturbance

Answer 44

Animal with electrolyte disturbances or ­Animal with a disease associated with AB disturbance and normal blood gas values

Question 45

example of mixed disturbance

Answer 45

cow with abomasal volvuus (hypochloremic metabolic alkalosis) and shock (metabolic acidosis- ↑ lactate)

Question 46

T/F mixed disturbances can occur when the compensatory response in moving in the wrong direction

Answer 46

true | Horse with low intestinal obstruction (colic) that is hypoventilated when anesthetized for surgery