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Principles of Anesthesia 1 (Summer 2023) > Exam 2 (ABG) > Flashcards

Exam 2 (ABG) Flashcards

1
Q

Alkalemia is the excessive production of?

A

OH⁻ (in relation to hydrogen ions)

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2
Q

Bicarb enters and leaves the body via?

A

The proximal tubules

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3
Q

H⁺ is reabsorbed via?

A

The distal tubules & collecting ducts

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4
Q

CO₂ enters leaves the body via?

A

The lungs

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5
Q

If PaCO₂ & HCO₃⁻ change in the same direction then?

A

It’s a primary disorder with secondary compensation

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6
Q

If someone’s PaO₂ on room air is 75 then on 100% it should be?

A

375 - 500 (Factor of 5)

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7
Q

What are the consequences of acidosis on the CV system?

A
  • Impaired contractility
  • Decreased arterial BP
  • Increased sensitivity to dysrhythmias
  • Decreased response to catecholamines
  • Decreased threshold for V-fib
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8
Q

At what pH does reduced catecholamine response happen?

A

At 7.1

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9
Q

What are the consequences of acidosis on the nervous system?

A
  • Obtundation
  • Coma
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10
Q

What are the consequences of acidosis on the pulmonary system?

A
  • Hyperventilation
  • Dyspnea
  • Respiratory muscle fatigue
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11
Q

What are the consequences of acidosis on metabolism?

A
  • Hyperkalemia
  • Insulin resistance
  • Inhibition of anaerobic glycolysis (decreased glucose production)
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12
Q

What is a flail chest?

A

Multiple broken ribs in various places

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13
Q

What are the 3 categories for respiratory acidosis?

A
  • Central ventilation control (brain)
  • Peripheral ventilation control (neuromuscular)
  • V/Q mismatch (respiratory)
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14
Q

What happens to bicarb & PaCO₂ in acute hypercarbia?

A
  • Bicarb rises slowly over 2-3 days
  • PaCO₂ increases
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15
Q

What does a PaCO₂ to Bicarb ratio of 10 : 1 mean?

A

The kidneys are compensating

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16
Q

What would the PaCO₂ to Bicarb ratio be for chronic hypercarbia?

A

10 : 3

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17
Q

A Pt’s PaCO₂ is 80 mmHg, what is the expected HCO₃⁻?

A

28 mmHg
(PaCO₂ is 40 mm higher than normal; apply 10 : 1 rule; then HCO₃⁻ should increase 4 meq/L)

18
Q

What happens to calcium in metabolic acidosis?

A

An increase in ionized calcium

19
Q

A left shift of the oxyhemoglobin curve is associated with?

A
  • Decreased PCO₂
  • decreased H⁺
  • decreased 2,3-DPG
  • decreased temp
  • HbF
20
Q

A right shift of the oxyhemoglobin curve is associated with?

A
  • Increased PCO₂
  • Increased H⁺
  • Increased 2,3-DPG
  • Increased temp
21
Q

If Bicarb is 12 mml/L then what is the expected PaCO₂?

A
  • 26 mmHg
  • 1.5 x 12 + 8= 26
  • 1.5 x HCO₃⁻ + 8
22
Q

Bicarb loss is compensated with?

A

A net gain of chloride ions

23
Q

What are causes metabolic acidosis with a normal anion gap?

A
  • Sodium chloride infusions
  • Diarrhea
  • Early renal failure
24
Q

What are causes for metabolic acidosis with a high anion gap?

A
  • Lactic- & Ketoacidosis
  • Renal failure
  • Poisonings
25
Q

What happens in the extacellular space with a high anion gap?

A

H⁺ combines with HCO₃⁻ leading to decreased bicarb availability

26
Q

What is the formula for calculating the anion gap?

A
  • Na⁺ - (Cl⁻ + HCO₃⁻) = 12 - 14 mEq/L
27
Q

What conditions complicate the anion gap?

A
  • Hypoalbuminemia
  • Hypophosphatemia
  • Both are negatively charged
28
Q

How is metabolic acidosis treated?

A

Treat the underlying cause

29
Q

What is the formula correcting acidosis with bicarb?

A

0.3 x base deficit (mmol/L) x kg

30
Q

What are causes for respiratory alkalosis?

A
  • Anxiety
  • pregnancy
  • salicylate overdose
  • hyperventilation
31
Q

What are the symptoms of respiratory alkalosis?

A
  • Lightheaded
  • visual disturbances
  • dizziness
32
Q

What happens to calcium in respiratory alkalosis?

A

It binds to albumin more readily

33
Q

What is Trousseau’s sign?

A

Hand cramping when BP is inflated on the arm

34
Q

What is Chvostek’s sign?

A

Irritability with taps on the facial nerve

35
Q

How many branches are the for the facial nerve?

A

5

36
Q

What are the branches of the facial nerve?

A

top to bottom:
- frontal (or temporal),
- zygomatic,
- buccal,
- marginal mandibular,
- cervical.

37
Q

What is metabolic alkalosis also called?

A

Volume depletion or volume overload alkalosis

38
Q

What are the causes of metabolic alkalosis?

A
  • Hypovolemia
  • vomiting
  • NG suction
  • diuretic therapy
  • Bicarb administration
  • Hyperaldosteronism
39
Q

How is metabolic alkalosis treated caused by vomiting or NG suction?

A

PPI’s

40
Q

How is volume overload alkalosis treated?

A

K⁺ sparing diuretics

Principles of Anesthesia 1 (Summer 2023) (14 decks)

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