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BRS YR2 > Arterial Blood Gases & Acid Base Regulation > Flashcards

Arterial Blood Gases & Acid Base Regulation Flashcards

1
Q

What should be in equilibrium with pCO2 (theoretical)?

A

Bicarbonate

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2
Q

What is FMetHb?

A

ferritin NOT ferrous in the haem- molecule that is unable to bind O2

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3
Q

What does acidosis correct?

A

alkalaemia

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4
Q

What does hyperventilation result in?

A

increased CO2 clearance

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5
Q

What are the 4 key aspects found from an ABG?

A
  • what is the type of imbalance?
  • what is the aetiology of imbalance?
  • any homeostatic compensation?
  • oxygenation?
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6
Q

How to assess compensation?

A
  • both values should change
  • only one indicates it is UNcompensated
  • changes in pH suggest partial compensation
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7
Q

What is base excess?

A

the difference between the actual bicarbonate and the expected bicarbonate

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8
Q

How do you calculate pH?

A

-log10[H+]

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9
Q

How do you calculate [H+]?

A

10^-pH

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10
Q

What is an acid?

A

Proton donor

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11
Q

What is a base?

A
  • proton acceptors
  • anionic (-ive) molecules
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12
Q

What proportion of acid is respiratory (CO2) or metabolic (lactic, HCl…)?

A

about 95:5

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13
Q

What does alkalosis correct?

A

acidaemia

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14
Q

What can cause a rapid compensation?

A
  • respiratory compensation
  • changes in ventilation change CO2 ventilation, altering pH
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15
Q

What can cause a slow compensation?

A
  • metabolic compensation
  • Changes in HCO3- and H+ retention/secretion in the kidneys, lead to changes in pH
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16
Q

How long does slow consumption take?

A

up to days

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17
Q

What is acidosis/alkalosis?

A

conditions that cause a change in pH

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18
Q

What is alkalaemia/acidaemia?

A

whether pH is above/below 7.35-7.45.

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19
Q

What are the different types of imbalance?

A
  • acidosis
  • alkalosis
  • normal
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20
Q

What are the different aetiologies of an imbalance?

A
  • respiratory (acidosis/alkalosis)
  • metabolic (acidosis/alkalosis)
  • mixed (respiratory and metabolic)
  • nroaml
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21
Q

What are the different forms of homeostatic compensation?

A
  • uncompensated
  • partially compensated
  • fully compensated
22
Q

What are the different forms of oxygenation?

A
  • Hypoxaemia
  • Normoxaemia
  • Hyperoxaemia
23
Q

How do you differentiate between respiratory and metabolic causes?

A

look at the CO2 level

24
Q

What would indicate compensation?

A
  • changes in PaO2 and PaCO2
  • changes in pH (if not normal, partial)
25
Q

What do changes in base excess indicate?

A

decrease if in respiratory alkalosis - for compensation (or vice versa)

26
Q

What is a normal PaCO2?

A

4.7-6.4 kPa

27
Q

What is a normal base excess?

A

-2 to 2

28
Q

What is a normal PaO2?

A

10-13.5kPa

29
Q

What can indicate partial compensation?

A

changes in PaCO2 or base excess that would help with alkalosis/acidosis but abnormal pH

30
Q

What is seen in uncompensated respiratory acidosis?

A
  • low pH
  • high PaCO2
  • normal BE
31
Q

What is seen in partially compensated respiratory acidosis?

A
  • low pH
  • high PaCO2
  • high BE
32
Q

What is seen in fully compensated respiratory acidosis?

A
  • normal pH
  • high PaCO2
  • high BE
33
Q

What is seen in uncompensated respiratory alkalosis?

A
  • high pH
  • low PCO2
  • normal BE
34
Q

What is seen in partially compensated respiratory alkalosis?

A
  • high pH
  • low PCO2
  • low BE
35
Q

What is seen in fully compensated respiratory alkalosis?

A
  • normal pH
  • low PCO2
  • low BE
36
Q

What is seen in uncompensated metabolic acidosis?

A
  • low pH
  • normal PaCO2
  • low BE
37
Q

What is seen in partially compensated metabolic acidosis?

A
  • low pH
  • low PaCO2
  • low BE
38
Q

What is seen in fully compensated metabolic acidosis?

A
  • normal pH
  • low PaCO2
  • low BE
39
Q

What is seen in uncompensated metabolic alkalosis?

A
  • high pH
  • normal PCO2
  • high BE
40
Q

What is seen in partially compensated metabolic alkalosis?

A
  • high pH
  • high PCO2
  • high BE
41
Q

What is seen in fully compensated metabolic alkalosis?

A
  • normal pH
  • high PCO2
  • high BE
42
Q

What mechanism is used to compensate for respiratory acidosis?

A

chronic: increased HCO3- retention

43
Q

What can cause respiratory acidosis?

A
  • insufficient removal of CO2 from lungs
  • COPD, asthma, OSA, hypoventilation
44
Q

What can cause respiratory alkalosis?

A

hyperventilation

45
Q

What mechanism is used to compensate for respiratory alkalosis?

A

chronic phase: reduced HCO3- retention/reabsorption

46
Q

What can cause metabolic acidosis?

A
  • increased acid production (diabetic ketoacidosis)
  • loss of bicarbonate (diarrhoea)
  • reduced acid secretion (kidney disease)
47
Q

What mechanism is used to compensate for metabolic acidosis?

A

hyperventilation

48
Q

What can cause metabolic alkalosis?

A
  • vomiting (loss of gastric secretions)
  • diuretics
  • antacid abuse

- H+ losing/HCO3- gaining conditions

49
Q

What mechanism is used to compensate for metabolic alkalosis?

A

hypoventilation

50
Q

What is the respiratory acid?

A

Carbonic acid from carbon dioxide

51
Q

What are the metabolic acids?

A
  • lactic acid
  • hydrochloric acid
  • keto acids
52
Q

What is the metabolic base?

A

Bicarbonate

BRS YR2 (67 decks)

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