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Clinical Chem Snoopy style > Blood Gases/pH/Buffers > Flashcards

Blood Gases/pH/Buffers Flashcards

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1
Q

Describe Acids vs Bases when dissolved

A

acids can DONATE H when dissolved
Bases can ACCEPT H when dissolved

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2
Q

How much H is produced daily?

A

150g H

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3
Q

What is the RR to maintain Acid Base balance

A

36-44
pH 7.35-7.45

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4
Q

T/F: pH =-log (H)
What is one up or one down pH do?

A

true
decrease in 1 pH is TENFOLD of H

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5
Q

Define strength in regards to acid base

A

ability to dissasociate in water

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6
Q

Describe a buffer system

A

weak acid and salt of conjugate base
resists pH changes w addition of base or acid
depends on PKA/pH

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7
Q

What is the principle buffer of plasma

A

Bicarb/carb acid

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8
Q

Adding hydrogen to the bicarb/carb acid buffer shifts the reaction which way?

A

forwards towards the carb acid

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9
Q

What is the buffer in Urine

A

protein/phosphate buffers ICF

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10
Q

What does the henderson-hasselbach equation do

A

acid-base relationship
PKA is pH equalibrium

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11
Q

Regulation of buffers
CO2?

A

in the lungs/kidneys
CO2 (aerobic) metabolic process/easily diffuses

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12
Q

T/F Most CO2 is free and diffuses into RBCs +h2o which results in Carb acid

A

true

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13
Q

What is the relationship between CO2 and H?

A

CO2 reduced/too alkaline Decreases H concentration

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14
Q

Increased Plasma does what to Na-H exchange and HCO3?

Decreased Plasma does what to Na-H exchange and HCO3?

A

Increased plasma decreases Na-H exchange and Dec HCO3

Decreased plasma Increases Na-H and increases HCO3

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15
Q

Other major functions of buffers include

What is the minimum urine pH? What does this limit

A

excreting H ions 50-100 acid excretion by kidney

Minimum pH of urine 4.6, limits free H excretion

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16
Q

What is the bicarb buff system?

A

dissolved CO2 is at equalibrium w CO2 in lungs, hyper/hypo ventilation

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17
Q

What controls bicarb concentration by excretion, prime with what?

A

Kidneys, prime with ammonium ions

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18
Q

What is the respiratory compensation mechanism?

A

O2 expelled

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19
Q

T/F: metabolic involves how kidney’s control excretion/absorption

A

True

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20
Q

What are acid base disorders?
What is acidosis caused by?

A

acidosis/alkalosis
<pH RR= acidemia/acidosis
Acidosis caused by primary metabolic/respiratory imbalance

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21
Q

What does acid and bicarb look like in primary metabolisis?
What is the compensation mech?

A

> acid <bicarb
compensation w Hyperventalation

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22
Q

> pH = what acid base disorder
What is the primary response

A

alkalemia/alkalosis
Primary respiratory decreased CO2
Kidney removes bicarb in urine

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23
Q

Describe
-Osis
-emia
-Acidemia
-alkelemia

A

-osis - process in body
-emia - corresponds to state in body
- acidemia - H conc increased with increased PCO2/decreased Bicarb
-Alkelemia - decreased H Decreased PCO2 increased Bicarb

24
Q

T/F: kidney is slower at resolving acid base disorders but does a better job

A

true

25
Q

T/F: primary respiratory alk/acidosis is a change in PCO2

A

TRUE

26
Q

T/F metabolic acidosis/alk bicarb levels/renal met

A

true

27
Q

What is compensation

A

response to maintain acid-base equalibrium by organ not associated w primary process

28
Q

What does fully compensated mean

A

pH has returned to normal and ratio is 20:1

29
Q

What does partially compensated mean

A

pH is approaching normal

30
Q

What does uncompensated mean

A

pH is abnormal and body has not compensated yet

31
Q

Describe metabolic acidosis
compensation of
overdose
excess
reduced
what is lost

A

compensation with Hyperventilation
overdose of acid substance
excess acidic ketones
reduced H ions
bicarb loss

32
Q

Describe Respiratory Acidosis
compensation
decreased
ineffective
decreased
compensation is

A

Hypoventilation
decreased PCO2
ineffective removal of CO2
decreased cardiac output
Compensation is slow/kidney response low pH

33
Q

Describe Metabolic Alkalosis
increased what
excessive
prolonged
increased use of
hypo…

A

increased bicarb/pH
excessive vomit of stomach acid
prolonged direutics
increased antiacids
hypokalemia

34
Q

Describe respiratory alkalosis

A

increased lung ventilation
too much CO2 loss
high altitudes
anxiety
aspirin overdose
pulmonary embolism

35
Q

What does H, pH, HCO3 look like in Metabolic acidosis

what is the compensation

A

H increased
pH decreased
HCO3 decreased
PC02 decreased

hyperventilation

36
Q

What does H, pH, HCO3 look like in Metabolic alkalosis

A

H decreased
pH increased
HCO3 increased
PCO2 increased

Hypoventilation

37
Q

What does H, pH, HCO3 look like in Respiratory acidosis

A

increase H
decrease pH
Increased PCO2
increased HCO3

38
Q

What does H, pH, HCO3 look like in Respiratory Alkalosis

A

decreased H
increased pH
Decreased PCO2
Decreased HCO3

39
Q

What is the total pressures of O,N,CO2

A

O 21%
N 78%
CO2 .03%

40
Q

What is the Trach pO2 and PCO2

A

PO2 149
PCO2 .2

41
Q

Alveolar PO2 PCO2

A

PO2 100
PCO2 36

42
Q

Artery PO2
PCO2

A

PO2 90
PCO2 40

43
Q

Tissue PO2
PCO2

A

PO2 20
PCO2 60

44
Q

Venous PO2
PCO2

A

PO2 40
PCO2 46

45
Q

Factors that influence O2 to the alveolar

A

destruction of alveoli
pulmonary edema
airway blockage

46
Q

Factors that influence O2 to the tissues

A

blood supply
diff of CO2/O2
Intrapulmonary shunty
anemia

47
Q

Oxy transports have 4 forms
O2HB
HHB
COHB
METHB

A

O2HB - ferrous
HHB - hgb-hgb w/o O2
COHB - CO2
METHB - oxidized

48
Q

Pt oxygen status is dependent on 4 parameters, explain them

A

oxy saturation (SO2)
Fractional Oxy/hgb (FO2HB)
Trends in oxygen sat by TC/SpO2
O2 dissolved in plasma (pO2)

49
Q

What are the only indicies of gas exchange

A

PO2/PCO2

50
Q

T/F: hgb is both acid-base and o2 buffer

Tissues increased O2
Lungs Increased CO2

A

T hgb is both acid-base and o2 buffer

Tissues increased CO2
Lungs increased O2

51
Q

Explain Blood gas analyzers

A

pH, PO2, PCO2
amperometric
automatic QC

52
Q

Explain measurement of PO2

A

clarke electrodes
error: build up of protein membrane
delay in fasting

53
Q

T/F: spectrophotmetric determiniation of O2 saturation is Co-oxemitry and has 4 wave lengths, what are the wave lengths

A

true
HHB, O2HB, COHB, METHB

54
Q

T/F: sensors can be thick/thin/macro and calibrations must be done a lot

A

ture

55
Q

+ base excess means —-
- Base deficit —–

A

+ base excess – metabolic alkalosis
- base deficit – metabolic acidosis

Clinical Chem Snoopy style (8 decks)

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