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Clinical Chemistry > Blood Gases, pH, and Buffer Systems > Flashcards

Blood Gases, pH, and Buffer Systems Flashcards

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1
Q

a substance that can yield a hydrogen ion (H+) or hydronium
ion when dissolved in water

A

Acid

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2
Q

a substance that can yield hydroxyl ions (OH-)

A

Base

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3
Q

substance that DONATES a proton in a reaction

A

Acid

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4
Q

substance that ACCEPTS a proton in a reaction

A

Base

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5
Q

the negative log of the ionization constant

A

pKa

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6
Q

pH in which the protonated and unprotonated forms are present in equal concentrations

A

pKa

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7
Q

Strong acids have pKa values of _____.

A

<3.0

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8
Q

Strong bases have pKa values ______.

A

> 9.0

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9
Q

For acids, raising the pH above the pKa will cause the acid to
_______ and yield ____.

A

dissociate, H+

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10
Q

For bases, lowering the pH below the pKa will cause the base to
release _____.

A

OH-

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11
Q

resists change in pH upon adding acid or base

A

Buffer

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12
Q

the combination of a weak acid or weak base and its salt

A

Buffer

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13
Q

Normal concentration for maintenance of H+ with pH

A

36 to 44 nmol/L, 7.34 to 7.44

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14
Q

Outside of the normal range for maintenance of H+ could mean?

A

Alterations in consciousness
Neuromuscular irritability
Tetany
Coma
Death

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15
Q

Arterial blood pH (nmol/L)

A

7.40 (40 nmol/L)

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16
Q

pH is _______ proportional to H+

A

inversely

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17
Q

the body’s first line defense against extreme changes in H+ concentration

A

Bicarbonate-carbonic acid system

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18
Q

Bicarbonate-carbonic acid system is consist of a weak acid such as?

A

carbonic acid (H2CO3), and its salt/conjugate base
bicarbonate (HCO3)

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19
Q

HCO3:H2CO3 ratio must be ____ to maintain normal pH

A

20:1

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20
Q

plays a role in plasma and red blood cells and is involved in
the exchange of sodium ion in the urine H+ filtrate

A

Phosphate buffer system

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21
Q

It is used for regulation of H+

A

Buffer systems

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22
Q

imidazole groups of histidine

A

Plasma proteins

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23
Q

most circulating proteins have a net ___________ and are
capable of __________.

A

negative charge, binding H+

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24
Q

Lungs is through ____________ or ____________.

A

gas exchange, respiration

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25
Q

Lungs has _____ and ______ term compensation.

A

rapid, short

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26
Q

Lungs controls?

A

carbon dioxide (CO2)

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27
Q

Kidneys is through ___________ or __________________.

A

reabsorption, excretion of bicarbonate

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28
Q

Kidneys has a _______ but _____ term compensation.

A

slow, long

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29
Q

Kidneys controls?

A

bicarbonate (HCO3)

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30
Q

Expresses the acid-base relationships in a mathematical formula.

A

Henderson-Hasselbalch Equation

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31
Q
A
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32
Q

formula for pH wherein kidneys is the numerator and lungs is the denominator.

A

pH = 6.1 + log salt/acid or
pH = 6.1 + log HCO3/H2CO3

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33
Q

formula for H2CO3?

A

H2CO3 = pCO2 x 0.0307

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34
Q

formula for HCO3

A

HCO3 = Total CO2 - H2CO3

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35
Q

pH is _______ proportional to bicarbonate.

A

directly

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36
Q

pH is ________ proportional to the partial pressure of carbon dioxide.

A

inversely

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37
Q

pH - arterial blood gas reference range

A

7.35 to 7.45

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38
Q

pCO2 (mmHg) - arterial blood gas reference range

A

35 to 45

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39
Q

HCO3 - arterial blood gas reference range

A

22 to 26

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40
Q

Total CO2 content (mmol/L) - arterial blood gas reference range.

A

23 to 27

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41
Q

pO2 (mmol/L) - arterial blood gas reference range

A

80 to 110

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42
Q

SO2 (%) - arterial blood gas reference range.

A

> 95

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43
Q

O2Hb (%) - arterial blood gas reference range.

A

> 95

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44
Q

pH is less than the reference range

A

Acidemia

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45
Q

pH is greater than the reference range

A

Alkalemia

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46
Q

a disorder caused by ventilatory dysfunction (a change in pCO2, the respiratory component)

A

Primary Respiratory Acidosis or Alkalosis

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47
Q

a disorder resulting from a change in the bicarbonate level (a renal or metabolic function)

A

Nonrespiratory disorder

48
Q

the body accomplishes to restore acid-base homeostasis by
altering the factor not primarily affected by the pathologic process.

A

Compensation

49
Q

implies that the pH is has returned to the normal range

A

Fully compensated

50
Q

implies that the pH is approaching normal. while compensation may successfully return the ratio to the normal 20:1, the primary abnormality is not corrected.

A

Partially compensated

51
Q

pH is abnormal, pCO2 or HCO3 is normal, but not both

A

Uncompensated

52
Q

pH of respiratory acidosis (increase or decrease)

A

decrease

53
Q

pH of respiratory alkalosis (increase or decrease)

A

increase

54
Q

pH of metabolic acidosis (increase or decrease)

A

decrease

55
Q

pH of metabolic alkalosis (increase or decrease)

A

increase

56
Q

disturbance in respiratory acidosis

A

hypoventilation, increased pCO2

57
Q

disturbance in respiratory alkalosis

A

hyperventilation, decrease pCO2

58
Q

disturbance in metabolic acidosis

A

decrease reabsorption and HCO-3, increase excretion

59
Q

disturbance in metabolic alkalosis

A

increase reabsorption and HCO-3, decrease excretion

60
Q

Compensation in respiratory acidosis

A

increase reabsorption, increase HCO-3

61
Q

Compensation in respiratory alkalosis

A

increase excretion, decrease HCO-3

62
Q

Compensation in metabolic acidosis

A

hyperventilation, decrease PCO2

63
Q

Compensation in metabolic alkalosis

A

hypoventilation, increase pCO2

64
Q

The amount of O2 available in atmospheric air depends on the?

A

Barometric pressure (BP)

65
Q

Partial pressure of O2 at sea level (in the body)

A

(760 mm Hg – 47 mm Hg) x 20.93%
149 mm Hg (at 37ºC)

66
Q

Partial pressure of CO2 at sea level (in the body)

A

(760 mm Hg – 47 mm Hg) x 0.03%
2 mm Hg (at 37ºC)

67
Q

1 Adult Hemoglobin (A1) can combine reversibly with up to __
molecules of O2.

A

4

68
Q

Hemoglobin not bound to O2 but capable of forming a bond when O2 is available.

A

Deoxyhemoglobin (HHb; reduced hemoglobin)

69
Q

Hemoglobin bound to CO. The bond between CO and Hb is reversible but is 200 times as strong as the bond between O2 and Hb.

A

Carboxyhemoglobin (COHb)

70
Q

Hemoglobin unable to bind O2 because iron (Fe) is in an oxidized rather than reduced state.

A

Methemoglobin (MetHb)

71
Q

The Fe3+ can be reduced by the enzyme __________________, which is found in the red blood cells.

A

methemoglobin reductase

72
Q

Shift to the right ODC if there’s an increased in?

A

body temp
hydrogen
CO2
2,3-DPG concentration

73
Q

shift to the left ODC if there’s _______ in body temp, hydrogen, pCO2, and 2,3-DPG concentration.

A

decrease

74
Q

in shift to the left ODC, if there’s an increased pCO2 is due to?

A

cigarette smoking
fetal hemoglobin

75
Q

Anticoagulant used in sample collection for arterial blood.

A

0.5 mL heparin/mL of blood (lyophilized)

76
Q

if there’s an excess heparin, there’s false _______ in blood pH

A

decrease

77
Q

Liquid form of heparin would cause erroneous results because?

A

excessive amount can dilute or possibly contaminate the sample if equilibrated with room air.

78
Q

Arterial and venous blood differ in ___, ____, and _____.

A

pH
pCO2
pO2

79
Q

Samples should be processed immediately within?

A

30 minutes

80
Q

Placing the blood sample in ice water quickly after the draw
reduces ________________ and ______________________.

A

cellular metabolism, accumulation of acidic by-products

81
Q

Glycolysis could result to _______ blood pH.

A

decreased

82
Q

Excess heparin causes ________ shift of blood pH

A

downward

83
Q

Low temperature can cause ________ oxygen solubility in blood and make a ________ in the oxyhemoglobin curve.

A

increased, left-shift

84
Q

used as sensing devices to measure pO2, pCO2, and pH.

A

Electrodes

85
Q

used in measuring pO2; the amount of current flow is an indication of the oxygen present

A

Amperometric

86
Q

used in measuring pCO2 and pH; a change in voltage indicates the activity of each analyte

A

Potentiometric

87
Q

negative electrode

A

cathode

88
Q

site to which cations tend to travel

A

cathode

89
Q

a site at which reduction occurs

A

cathode

90
Q

the gain of electrons by a particle (atom, molecule, or ion)

A

Reduction

91
Q

positive electrode

A

anode

92
Q

site to which anions migrate

A

anode

93
Q

site at which oxidation occurs

A

anode

94
Q

the loss of electrons by a particle (atom, molecule, or ion)

A

Oxidation

95
Q

formed when two opposite electrodes are immersed in a liquid
that will conduct a current.

A

Electrochemical cell

96
Q

measure the amount of current flow in a circuit that is related to amount of O2 being reduced at the cathode.

A

Clarke electrodes

97
Q

A ____________ placed in the circuit between the anode cathode
measures the movement of electrons (current).

A

microammeter

98
Q

determines blood pH by the potential difference between a
measuring electrode and a reference electrode

A

Sanz glass electrode

99
Q

reference electrodes:

A

Ag-AgCl electrode
Calomel (Hg2C12)

100
Q

use to measure pCO2

A

Severinghaus Electrode

101
Q

an outer semi-permeable membrane that allows CO2 to diffuse into a layer of electrolyte, usually a bicarbonate buffer, covers the glass pH electrode.

A

Severinghaus Electrode

102
Q

the most important factor that influences the assay

A

Temperature

103
Q

for each degree of fever in the patient, pO2 will fall___ and pCO2
will rise ___.

A

7%, 3%

104
Q

Lactic acidosis is the excessive accumulation of lactic acid in plasma, either due to __________, ________________ by the renal and hepatic, or _______________.

A

overproduction
defective removal
underutilization

105
Q

It is produced from pyruvic acid by the action of LDH and NAD.

A

Lactic acidosis

106
Q

Lactic acidosis is usually seen in cases of ___________.

A

tissue hypoxia

107
Q

Lactic acidosis is characterized by _______________ and ___ blood pH (____).

A

elevated anion gap, low (<7.35)

108
Q

Common cause of Lactic acidosis:

A

L-lactate

109
Q

Reference range: venous blood lactate

A

5 to 20 mg/dl

110
Q

Reference range: arterial blood lactate

A

3 to 7 mg/dL

111
Q

Interpretation:
indication of sepsis

A

> 18 mg/dL

112
Q

What is the form of L-lactate?

A

levorotatory

113
Q

What is the form of D-lactate?

A

dextrorotatory

114
Q

Type of lactic acidosis that is related with decreased oxygenation with tissue hypoxia.

A

Type A-Hypoxic Lactic Acidosis

115
Q

Type of lactic acidosis that is associated with diseases and high demand of cellular oxygen, no tissue hypoxia.

A

Type B-Metabolic Lactic Acidosis

Clinical Chemistry (2 decks)

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