Arterial blood Gases

Question 1

With the hinderson Hasselback equation simplified, H is proportional to ____ / _____ which means that if CO2 goes down, what must hapen to HCO3 compensitority

Answer 1

PCO2 / HCO3;

Question 2

What is the normal pH of the blood?

Answer 2

7.36 to 7.44

Question 3

What is the normal level of HCO3

Answer 3

22-26 mEq/L

Question 4

What is the normal level of PCO2

Answer 4

36-44 mmHg

Question 5

PCO2 represents the __________ component

Answer 5

respiratory

Question 6

HCO3 represents the ______ and ______ components

Answer 6

metabolic and chemical

Question 7

What controls the respiration rate due to regulation?

Answer 7

carotid cehmoreceptors

Question 8

What does the chemoreceptors cause you to do if you have too high of H concentration

Answer 8

breather faster

Question 9

What system is important for the nonvolitile acids and the volitile acids?

Answer 9

Renal; Lungs

Question 10

What happens in the kidneys if there is too high a H concentration in the blood?

Answer 10

the kidneys will hold onto HCO3 to offset the inc of H in the blood from CO2

Question 11

What are the three forms of regulation in the body and what three substances make up the non dominant one?

Answer 11

Respiratory, Metabolic and chemical; phosphate, protein, hemoglobin (for chemical)

Question 12

What is the difference between acidosis and acidemia?

Answer 12

acidosis is the predisposition to getting acidemia but is not yet having acidemia

Question 13

What does the term mixed mean?

Answer 13

more than one type of acid-base abnormality

Question 14

respiratory acid-base disorders are compensated by

Answer 14

metabolic mechanisms

Question 15

metabolic acid-base disorders are compensated by

Answer 15

respiratory mechanism

Question 16

How long does it take the respiratory compensation to take effect and how long for full effect?

Answer 16

30mins, 12-24 hrs

Question 17

how long does it itake the metabolic compenstation to take effect and how long for full effect?

Answer 17

6-12h, 3-5 days

Question 18

How many equations are there? Why are there not 8?

Answer 18

due to the fast compensation for the respiratory system, when there is a metabolic acidosis or alkilosis there is no acute or chronic reaction from the lungs; its always fast.

Question 19

What do the following numbers mean? 7.32/40/18/26

Answer 19

pH/PaCO2/PaO2/HCO3

Question 20

What is SaO2 and BE?

Answer 20

oxygen saturation and base excess

Question 21

what are the two types u cant have together?

Answer 21

respiratory alkilosis and respiatory acidosis

Question 22

If pH is opposite of PaCO2 then what type of acid-base disorder is it? What about if HCO3 is opposite?

Answer 22

respiratory; respiratory

Question 23

What is the normal values for PaCO2 and HCO3?

Answer 23

36-44; 22-28

Question 24

How do you tell what type of mix they have using > or < HCO3 and > or < PaCO2

Answer 24

Metabolic: >PaCO2 - respiratory acidosis
HCO3 - metabolic alkalosis
<HCO3 - metabolic acidosis

Question 25

what is the anion gap equation? what is normal anion gap? What are some unmeasured anions and cations?

Answer 25

anion gap = Na - (Cl + HCO3); 12; albumin, phosphate, organic anions; K, Ca, Mg

Question 26

So which acid-base disorder can be spit up into high anion gap and non-anion gap?

Answer 26

metabolic acidosis

Question 27

What is the anion gap equation?

Answer 27

change anion gap / change HCO3

Question 28

A normal delta anion gap/delta HCO3 is ____

Answer 28

1

Question 29

What does it mean if the ratio is less than 1?

Answer 29

its concurrent non-anion gap metabolic acidosis

Question 30

What does it mean if the ratio is more than 1?

Answer 30

its concurrent metabolic alkalosis

Question 31

So for high anion gap metabolic acidosis it could be 3 things:

Answer 31

with non anion-gap metabolic acidosis if the ratio is less than 1; with metabolic alkalosis if the ratio is greater than one; or normal (where it equals 1)

Question 32

What is normal PaO2?

Answer 32

80-100

Question 33

What is normal SaO2?

Answer 33

>95%

Question 34

What is normal BE?

Answer 34

-2 - 2 mEq/L

Question 35

What does less than -2 mean?

Answer 35

metabolic acidosis

Question 36

What does more than 2 mean?

Answer 36

metabolic alkilosis

Question 37

What are some adverse events of Acidemia?

Answer 37

CV, hyperventilation,

Question 38

What are some causes of Respiratory acidosis?

Answer 38

not being able to expel CO2 - so like airway obstruction, COPD, asthma, brain injury

Question 39

What is therapy for respiratory acidosis?

Answer 39

tx underlying cause, avoid sedatives, consider alkali therapy in severe cases

Question 40

What are some causes of metabolic acidosis?

Answer 40

High anion gap caused by MUD PILES Non-anion gap - diarrhea, renal tubular acidosis, carbonic anhydrase inhibitors (topiramate), renal insufficiency, mineralocorticoid deficiency

Question 41

what does mud piles refer to and what does it stand for?

Answer 41

``` Drugs that induce metabolic acidosis: Methanol Uremia Diabetic ketoacidosis (can be metabolized) Propylene glyco Iron/isoniazid Lactate Ethylene glycol salicylates ```

Question 42

how do you treat metabolic acidosis?

Answer 42

tx underlying cause; avoid caustive agents; avoid metformin, nitroprusside and NRTI, consider alkali therapy in severe cases or based on underlying cause

Question 43

What are the 5 drugs for alkali therapy?

Answer 43

Na Bicarb, Na acetate, Na citrate, Na lactate, Tromethamine

Question 44

Why does Tromethamine have advantages?

Answer 44

It doesn't have Na and it doesnt regenerate CO2

Question 45

What are some side effects of alkalemia?

Answer 45

CV, hypoventilation

Question 46

What are some causes of respiratory alkalosis?

Answer 46

hyperventiation (anxiety, fever, pain, pregnanacy, lung disease, etc)

Question 47

What is the tx for respiratory alkalosis?

Answer 47

tx underlying cause, avoid causative agents, consider rebreathing in symptomatic cases

Question 48

What are some causes of metabolic alkalosis?

Answer 48

vomiting, gastric aspiration, loop or thiazide diuretics, posthypercania, hyperaldosteronism, corticosteroids, licorice, alkali ingestions, exchange resin and antacids, penicillin, hypercalcemia, hypomagnesemia, hypokalemia

Question 49

How do you tx metabolic alkalosis?

Answer 49

tx underlying cause, avoid caustive agents, consider hypdrochloric acid in severe cases

Question 50

Excessive vomiting is most likely to cause?

Answer 50

metabolic alkilosis