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JL Respiratory > Biochemistry > Flashcards

Biochemistry Flashcards

1
Q

Where is most of [H+] in our body excreted?

A

Via urine

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2
Q

Is urine acidic or alkaline?

A

Acidic

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3
Q

Is buffering of H+ a temporary measure?

A

Yes

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4
Q

Give the bicarbonate equation.

A

[H+] + HCO3 = H2CO3 = CO2 + H2O

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5
Q

What is carbonic acid (H2CO3) removed as?

A

CO2

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6
Q

What is the equation which underpins all acid-base stuff?

A

[H+] (alpha sign) (pCO2/[HCO3])

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7
Q

What is the solution for too much H+ or too much CO2?

A

Compensation

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8
Q

When you’ve got too much H+, what occurs as compensation?

A

Lungs blow off CO2

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9
Q

When you’ve got too much CO2, what occurs as compensation?

A

The kidneys get rid of [H+]

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10
Q

What is acidaemia?

A

Increased [H+]

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11
Q

What is alkalaemia?

A

Decreased [H+]

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12
Q

What does acidosis tend to cause?

A

Increased [H+]

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13
Q

What does alkalosis tend to cause?

A

Decreased [H+]

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14
Q

What is the respiratory component?

A

pCO2

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15
Q

What is the metabolic component?

A

HCO3

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16
Q

What is an increase in [H+], due to increase pCO2?

A

Respiratory acidosis

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17
Q

What is a decrease in [H+], due to decreased pCO2?

A

Respiratory alkalosis

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18
Q

What is increased [H+], due to decreased HCO3?

A

Metabolic acidosis

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19
Q

What is decreased [H+], due to increased HCO3?

A

Metabolic alkalosis

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20
Q

What is the respiratory compensation for metabolic acidosis?

A

Blow off CO2

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21
Q

What is the metabolic compensation for respiratory acidosis?

A

Excrete more H+

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22
Q

What is the compensatory response for increased pCO2 (respiratory acidosis)?

A

Increased HCO3

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23
Q

What is the compensatory response for decreased pCO2 (Respiratory alkalosis)?

A

Decreased HCO3

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24
Q

What is the compensatory response for decreased HCO3 (metabolic acidosis)?

A

Decreased pCO2

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25
Q

What is the compensatory response for increased HCO3 (metabolic alkalosis)?

A

Increased PCO2

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26
Q

What are the 4 arterial blood gases?

A

H+
pCO2
HCO3
pO2

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27
Q

Give three causes of respiratory acidosis?

A

Choking
Bronchopneumonia
COAD

28
Q

Give three causes for respiratory alkalosis?

A

Hysterical over-breathing
Mechanical over-ventialtion
Raised intracranial pressure

29
Q

Give three causes of metabolic acidosis?

A

Imparied [H+] excretion
Increased [H+] production or ingestion
Loss of HCO3

30
Q

Give three causes of metabolic alkalosis?

A

Loss of [H+] in vomit
Alkali ingestion
Potassium deficiency

31
Q

What is the normal range of pH?

A

7.35 - 7.45

32
Q

What must PaO2 always be interpreted against?

A

The inspired O2

33
Q

What is PaO2?

A

the partial pressure of oxygen in arterial blood

34
Q

What is the normal range breathing air of PaO2?

A

9.3 - 13.3 kPa

35
Q

What is the normal range for PaCO2?

A

4.7 - 6 kPa

36
Q

The body tries to compensate for a metabolic alkalosis by raising PaCO2, what does the body do physically?

A

Hypoventilating

37
Q

The body will try to compensate for a metabolic acidosis by lowering PaCO2, what does the body do physically?

A

Hyperventialte

38
Q

What is the normal range of base excess?

A

-2 to +2 mmol/l

39
Q

What is base escess?

A

The measure of how much base has to be removed or added to the system to correct the pH in standard conditions. It is a measure of metabolic acidosis or alkalosis.

40
Q

What does a negative BE indicate?

A

Metabolic acidosis

41
Q

What does a positive BE indicate?

A

Metabolic alkalosis

42
Q

What does the kidney do to compensate for respiratory acidosis?

A

Creates a metabolic alkalosis by retaining bicarbonate

43
Q

What does the kidney do to compensate for respiratory alkalosis?

A

Creates a metabolic acidosis by excreting bicarbonate

44
Q

What does hypercapnic mean?

A

High pCO2

45
Q

What is polydipsia?

A

Excessive thirst

46
Q

If the patient has metabolic acidosis, and the pCO2 is normal, what does this indicate?

A

No respiratory compensation

47
Q

What is hypoxia?

A

Lack of oxygen

48
Q

What is hypoxaemia?

A

Low oxygen levels within the blood (pO2 and SaO2 combined)

49
Q

Give four causes of tissue hypoxia

A
  1. Anaemic hypoxia
  2. Perfusional hypoxia
  3. Toxic hypoxia
  4. Hypoxaemic hypoxia
50
Q

What causes anaemic hypoxia?

A

Lack of Hb

51
Q

What causes perfusional hypoxia?

A

Poor CO

52
Q

What causes toxic hypoxia?

A

Failure of release of O2 at tissue level

53
Q

What causes hypoxaemic hypoxia?

A

Low pO2 and SaO2 - respiratory insufficiency

54
Q

Name 4 buffers

A
  1. Haemoglobin
  2. Bicarbonate
  3. Ammonium
  4. Phosphate
55
Q

Can overcompensation occur?

A

NO

56
Q

Name three causes of respiratory acidosis with metabolic compensation

A

Chronic type 2 respiratory failure: COPD, DF, kyphoscoliosis

57
Q

Name 3 causes of metabolic alkalosis with respiratory compensation?

A

Milk alkali syndrome
Vomiting
Severe hypokalaemia

58
Q

Give 5 causes of metabolic acidosis with respiratory compensation?

A 
Sepsis
DKA
Poisoning
Drugs
Lactate
59
Q

What are general causes of respiratory alkalosis with metabolic compensation?

A

Chronic hyper-ventilatory states

60
Q

What are 9 causes of high anion gap? (AMUDPILES)

A

A - alcohol (alcohol dissociates to become a weak acid)
M - methanol (causes blindness)
U - uraemia (failure to reabsorb HCO3 and excrete H+
D - DKA (ketones are dehydrogenated alcohols, and dissociate to acid)
P - paraquat (very nasty poison, universally lethal
I - infection (commonest, localised tissue hypoxia leads to…)
L - lactic acid (product of anaerobic respiration, and tissue necrosis)
E - erythlene gylcol (antifreeze)
S - salicylates (aspirin causes respiratory alkalosis, then metabolic acidosis

61
Q

What can these 5 things occur as a result of? Addisons disease, high output fistulas, RTA I, II, IV, Acetazolamide therapy, diarrhoea?

A

Normal anion gap

62
Q

Who were pink puffers traditionally though to be?

A

Emphysema patients

63
Q

What to pink puffers react to hypoxaemia by doing?

A

Hyperventilating

64
Q

Who were blue bloaters traditionally though to be?

A

Chronic bronchitis patients

65
Q

What do blue bloaters not do?

A

React to hypoxia or hyperventilate

66
Q

hi

A

hi

67
Q

In acid base balance, what is being regulated?

A

Hydrogen ion concentration ([H+], pH)

JL Respiratory (27 decks)

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