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Physiology > Assessment of Acid-Base Status > Flashcards

Assessment of Acid-Base Status Flashcards

1
Q

What is the isohydric principle?

A

It is the phenomenon where multiple A/B pairs in solution are in equilibrium tied to each other via H+

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2
Q

How is the isohydric principle important in the overall A/B balance?

A

Any change in H+ will change the balance of a single buffer system that will also change the balance of all the other buffer systems as the H+ ions shift back and forth from each system.

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3
Q

Why does only one buffer system need to be examined in order to understand the [H+] in the buffer space?

A

Due to the isohydric principle all the buffer systems are linked via a common H+

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4
Q

For medical purposes what are the 1st, 2nd and 3rd most important buffer systems?

A

1st: Bicarbonate
2nd: Hb
3rd: Phosphate

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5
Q

What is used to examine the acid-base status of the body?

A

Arterial blood - NOT venous blood because the arterial blood is highly buffered and pH controlled but venous blood is not.

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6
Q

What buffer system is an open system?

A

Bicarbonate

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7
Q

What buffer systems are closed systems?

A

Phosphate and protein (Hb)

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8
Q

What is the bicarbonate system?

A

•Open Buffer: CO2 + H2O HCO3– + H+ (pK = 6.1)

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9
Q

What is the Hb system?

A

•Closed Buffer: Hb-H+ Hb + H+ (pK = 7.0)

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10
Q

What happens with insufficient CO2 removal?

A

Respiratory acidosis -> acidemia

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11
Q

What happens with excessive CO2 removal?

A

Respiratory alkalosis -> alkalemia

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12
Q

What can happen as an A/B renal disturbance?

A

Improper H+ and HCO3- secretion or reabsorption

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13
Q

what happens with extra-renal disturbances that can lead to A/B imbalance?

A

Excessive CO2 or H+ formation

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14
Q

How rapid is kidney compensation for lung dysfunction?

A

Slow

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15
Q

How rapid is lung compensation for kidney dysfunction?

A

Rapid

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16
Q

What occurs in respiratory acidosis?

A

Increased PaCO2

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17
Q

What happens with respiratory alkalosis?

A

Decreased PaCO2

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18
Q

What happens with metabolic acidosis?

A

Low [HCO3-]

19
Q

What happens with metabolic alkalosis?

A

High [HCO3-]

20
Q

What is the anion gap?

A

Accounts for unmeasured anions that must be present to neutralize the charge of the measured cation, Na+

21
Q

What is the anion gap used for?

A

It allows you to differentiate between acid-base disorders that are due to renal/GI problems or other metabolic disorders.

22
Q

What does a normal anion gap indicate?

A

It indicates a renal/GI problem

23
Q

What does a high anion gap indicate?

A

It indicates other metabolic disorders (diabetes)

24
Q

What is the normal range for pH?

A

7.35-7.45

25
Q

What is the normal range for PaCO2?

A

35-45 mmHg

26
Q

What is a double A/B disturbance?

A

It occurs if the plasma pH is abnormal and both the HCO3- and PaCO2 levels are abnormal and causes severe alkalosis or acidosis.

27
Q

What is a mixed A/D disturbance?

A

When the plasma pH is normal and both the HCO3- and CO2 are not normal.

Low CO2 with low HCO3 or vice versa

28
Q

Can secondary compensations make up for primary disturbances?

A

Yes but they can never be complete.

29
Q

What is the compensation for metabolic acidosis?

A

Decrease CO2

30
Q

What is the more common acid base disorder?

A

Acidosis

31
Q

What A/B is more easily regulated?

A

Acidotic distrubances. Respiratory ones in particular are much less complicated.

32
Q

What is the cause of primary respiratory acidosis?

A

Hypoventilation (COPD/barbituate posioning)

33
Q

What is the result of primary respiratory acidosis?

A

Increased PaCO2 and decreased pH

34
Q

What is the compensation for primary respiratory acidosis?

A

Increased HCO3- retention via CO2’s effect on the PT

35
Q

What is the cause of primary respiratory alkalosis?

A

Hyperventilation

36
Q

What is the result of primary respiratory alkalosis?

A

Decreased PaCO2 and increased pH

37
Q

What is the compensation for primary respiratory alkalosis?

A

Decreased HCO3- retention via reverse CO2 effect on PT

38
Q

What is the cause of primary metabolic acidosis?

A

Renal and extrarenal causes:

  • Diabetes (larger anion gap)
  • Renal Increased H+ Retention (normal anion gap)
39
Q

What is the result of primary metabolic acidosis?

A

Increased H+ and/or decreased HCO3- leading to decreased pH

40
Q

What is the compensation for primary metabolic acidosis?

A

Increased CO2 elimination via ventilation

41
Q

What is the cause of primary metabolic alkalosis?

A

Renal and extrarenal causes:

  • Chronic Potassium Depletion
  • Dehydration
42
Q

What is the result of primary metabolic alkalosis?

A

Decreased H+ and/or increased HCO3- leading to increased pH

43
Q

What is the compensation for primary metabolic alkalosis

A

Increased CO2 retention and a decrease in ventilation

44
Q

If there is chronic depletion of K+ ions, what happens to the urine?

A

It will be very acidic

Physiology (81 decks)

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