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Sp: Intro to Anes > Blood Gas Analysis > Flashcards

Blood Gas Analysis Flashcards

1
Q

why is precise regulation of acid/bases needed?

A

enzyme activity
O2 transport
chemical rxn rate

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2
Q

normal blood pH

A

7.35-7.45

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3
Q

acidemia

A

blood pH <7.35

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4
Q

alkalemia

A

blood pH >7.35

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5
Q

acidosis

A

process that lowers pH

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6
Q

alkalosis

A

process that raises pH

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7
Q

3 ways body regulates acids/bases

A

buffers
pulm excretion of CO2 (mins)
renal elim of acids (days)

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8
Q

buffer

A

substance in a solution that prevents extreme changes in pH

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9
Q

buffer equations

A

henderson hasselbach

pH = pKa + log ( [base]/[conjugate acid])

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10
Q

pKa

A

pH where acid is 50% protonated and 50% deprotonated

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11
Q

pKa measures

A

strength of acid

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12
Q

buffers in blood

A

bicarbonate
hemoglobin buffer system
protein buffer
phosphate
ammonia

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13
Q

bicarbonate buffer

A

CO2 +H2O –> H2CO8 –> H+ + HCO3-

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14
Q

bicarbonate rxn speed

A

slow

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15
Q

how does the body speed up the bicarbonate rxn

A

carbonic anhydrase

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16
Q

where is carbonic anhydrase located

A

endothelium
erythrocytes
kidneys

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17
Q

hgb buffer

A

hgb contains multiple histidines
imidizole size chains
H+ binds to rings
displaces O2

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18
Q

hgb buffer depends on what

A

the bicarb buffer to move CO2 intracellular

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19
Q

% of CO2 in blood

A

70% buffered
23% carbaminohemoglobin (not buffered)
7% CO2 dissolved in plasma (PaCO2)

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20
Q

bohr effect

A

CO2 and H+ effect Hbg affinity for O2

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21
Q

high CO2/low pH does what to the Hb-O2 curve

A

right shift

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22
Q

haldane effect

A

deoxyhemoglobin has 3.5% greater affinity for CO2 than hb
PO2 is low in venous blood
hgb carries more CO2

23
Q

central chemoreceptors

A

respond to changes in CSF pH
H+ activates chemoreceptors
incr MV

24
Q

MV increases ______ for every _____ increase in CO2

A

MV increases 1-4L/min for every 1 mmHg increase in PaCO2

25
Q

peripheral chemoreceptros

A

carotid bodies
sensistive to:
PaO2
PaCO2
pH
arterial perfusion

26
Q

aortic bodies nerve

A

vaguys

27
Q

carotid bodies

A

glosopharyngeal

28
Q

renal compensation mechanisms

A

reabsorption of filtere HCO3-
excretion of acids
ammonia

29
Q

venous gas pH

A

0.03-0.04 les than arterial

30
Q

venous pO2

A

less than PaO2

31
Q

venous gas is used for

A

trends

32
Q

temperature and solubility relationship

A

inversely proportional

33
Q

at a lower temp ______ goes into solution

A

at a lower temp more gas goes into solution

34
Q

alpha stat

A

measures all blood gases at 37F
(raise the temp of the sample)

35
Q

alpha stat pH

A

try to keep pt at 7.4pH

36
Q

pt vs alpha stat pH

A

pt pH is higher than the alpha stat will read

37
Q

pH stat

A

taken at temp of pt

38
Q

pH stat pH

A

keep pH at 7.4

39
Q

drawing a pH stat from hypothermic pt

A

add CO2 to mx pH of 7.4

40
Q

lower pH and higher CO2 improve

A

CV perfusion
cerebral O2

41
Q

hypoventilation

A

increases CO2
increases H+
decreases pH

42
Q

hyperventilation

A

decreases CO2
decreases H+
increases pH

43
Q

base excess/base deficit

A

amount of strong acide or strong base required to return 1L of whole blood to pH of 7.4 at a PCO2 of 40 mmHg

44
Q

anion gap

A

difference between measured cations and measured anions

45
Q

anion gap equation

A

AG = Na+ - (Cl- + HCO3-)

46
Q

normal anion gap

A

8-12 mEq/L

47
Q

most common unmeasures anions

A

lactic acid
ketones

48
Q

anion gap step 1

A

determin oxygenation status
PaO2 ~ FiO2*5

49
Q

anion gap step 2

A

determine alkalemia or acidemia
pH

50
Q

anion gap step 3

A

determine respiratory or metabolic

resp:
normal PacO2 = 35-45
meta:
normal HCO3- = 22-28

51
Q

anion gap step 4 (respiratory origin)

A

acute respiratory acidosis
- pH change 0.08 for every 10 mmHg in PCO2 from 40

chronic
- pH change 0.03 for every 10mmHg in PCO2 from 40

52
Q

anion gap step 5 (metabolic)

A

calculate anion gap

AG = Na-(Cl+HCO3)
Normal: 8-12

53
Q

anion gap step 6

A

calculate delta gap

(AG - 12) + HCO3-

delta gap < 22: concurrent non gap
delta gap > 26: concurrent metabolic acidosis

54
Q

anion gap step 7

A

respiratory compensation?

metabolic acidosis
- PCO2 = (0.7HCO3)+21
or
- PCO2 = (1.5HCO3)+8 (winter formula)

PCO2 > PCO2 calculated = concurrent resp acidosis
PCO2 < PCO2 calculated = concurrent resp alkalosis

Sp: Intro to Anes (12 decks)

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