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RES Biweekly 3 > Fouty- Arterial Blood Gas > Flashcards

Fouty- Arterial Blood Gas Flashcards

1
Q
A

resp. alkalosis?

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2
Q
A

resp. acidosis?

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3
Q

3 main things arterial blood gases provide info on:

A

pH
adequacy of ventilation (PCO2)
adequacy of oxygenation (PaO2)

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4
Q

how to calculate P(A-a)O2 gradient

A

alveolar gas equation (PAO2)-PaO2 measured

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5
Q

_____ is directly related to alveolar ventilation

A

arterial CO2

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6
Q

Henderson-Hasselbach equation

A

pH=pKa + log (HCO3-)/s x PCO2

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7
Q

s in HH equation is what

A

solubility of CO2

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8
Q

normal pH in people (range)

A

7.36-7.44

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9
Q

normal solubility of CO2

A

0.03

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10
Q

PCO2 (lung or kidney)

A

lung

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11
Q

HCO3- (lung or kidney)

A

kidney

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12
Q

decrease in HCO3- and PCO2 stays the same

A

uncompensated metabolic acidosis

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13
Q

HCO3- increased and PCO2 remains the same

A

uncompensated metabolic alkalosis

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14
Q

increase in PCO2 and HCO3- the same

A

uncompensated respiratory acidosis

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15
Q

what decreases when PCO2 is increased

A

alveolar ventilation

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16
Q

decrease in PCO2 and HCO3- hasn’t changed

A

uncompensated respiratory alkalosis

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17
Q

2 things that make pH alkalinic

A

less PCO2
more HCO3-

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18
Q

2 things that make pH acidotic

A

decrease in HCO3-
increase in PCO2

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19
Q

____ and ____ are pathologic processes in which the values for acid and base are out of the normal range

A

acidosis and alkalosis

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20
Q

____compensation is fast

A

respiratory compensation

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21
Q

___ compensation is slow

A

metabolic

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22
Q

decreased HCO3-, and then decrease PCO2

A

compensated metabolic acidosis

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23
Q

causes of metabolic acidosis

A

seizure
DKA
severe diarrhea

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24
Q

in compensated metabolic acidosis, does the pH go back to normal due to increased alveolar ventilation

A

no, it gets it back into normal range but not all the way normal

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25
Q

cause of increase PCO2

A

hypoventilation
too much morphine

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26
Q

increase in PCO2 (respiratory acidosis), in 3-5 days, kidneys will compensate by what

A

increasing HCO3- (kidneys get pH back to normal)

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27
Q

Acidemia and alkalemia denote that the process has resulted in an abnormal pH. This frequently indicates that the initial acid-base abnormality is _________

A

uncompensated or inadequately compensated

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28
Q

blood pH>/= 7.45

A

alkalemia

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29
Q

denotes a blood pH </= 7.35

A

acidemia

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30
Q

body handles acidemia better than what

A

alkalemia

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31
Q

acute change of PaCO2 of 10 mmHg leads to pH change of ____

A

0.08

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32
Q

if PaCO2 is down, what is increased

A

alveolar ventilation

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33
Q

if PaCO2 is increased, what is decreased

A

alveolar ventilation

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34
Q

main way CO2 is carried from tissues to lungs

A

HCO3-

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35
Q

PCO2 correlates linearly w/ _____ content over human range

A

CO2

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36
Q

normal range of PaCO2

A

38-42 mmHg

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37
Q

normal range of HCO3

A

22-26 meq/L

38
Q

PaCO2</= 35 mmHg

A

primary respiratory alkalosis

39
Q

PaCO2>/= 45 mmHg

A

primary respiratory acidosis

40
Q

HCO3- >/=28 meq/L

A

primary metabolic alkalosis

41
Q

HCO3- </= 22 meq/L

A

primary metabolic acidosis

42
Q
A

uncompensated respiratory acidosis

43
Q

if PaCO2 changes by 10, HCO3- changes by ____

A

1

44
Q

change in pH is directly a result of change in ____

A

PaCO2

45
Q
A

uncompensated respiratory alkalosis

46
Q
A

primary respiratory alkalosis and primary metabolic alkalosis

47
Q
A

primary metabolic acidosis

48
Q

hyperventilation is PaCO2 < ____

A

36 mmHg

49
Q

compensation for metabolic acidosis

A

hyperventilation

50
Q

Winter’s formula used for what

A

to check is there is adequate compensation for metabolic acidosis

51
Q

Winter’s formula:

A

PaCO2= 1.5HCO3 + 8 +/- 2

52
Q

for normal respiratory compensation, pH does not return to _____

A

normal range

53
Q

point of compensation

A

to keep us from dying acutely from metabolic acidosis while physician tries to correct it

54
Q
  • lactic acidosis
  • ketoacidosis
  • toxic ingestions
  • loss of HCO3
    • severe diarrhea
A

causes of metabolic acidosis

55
Q
A

primary respiratory alkalosis w/ metabolic compensation

56
Q
A

primary metabolic acidosis with some respiratory compensation (went from 40 to 30)

57
Q

reasons for metabolic acidosis with inadequate respiratory compensation (can’t blow out CO2 like they should)

A

neuromuscular weakness w/ severe diarrhea
ILD
narcotics

58
Q

if this person was well yesterday and this is their ABG

A

metabolic acidosis

59
Q

this ABG has occurred over weeks

A

metabolic compensation

60
Q

aspirin toxicity

A

respiratory alkalosis w/ metabolic acidosis

61
Q

long standing asbestos exposure

A

induced lung disease w/ respiratory alkalosis w/ metabolic compensation

62
Q

if it’s an acute event, what doesn’t have time to kick in

A

metabolic compensation

63
Q

If they can’t blow down CO2 enough, means they have underlying reason/weakness and cant generate _____to blow CO2 down

A

alveolar ventilation

64
Q

lactic acidosis
ketoacidosis
renal failure
diarrhea
aspirin

A

common causes of primary metabolic acidosis

65
Q

vomiting
diuretics
hypokalemia
excessive tums
hyperaldosteronism

A

causes of primary metabolic alkalosis

66
Q

retain arterial CO2

A

hypoventilation

67
Q

ILD
neurologic injuries
aspirin intoxication
hypoxia

A

causes of primary respiratory alkalosis

68
Q

Takes time (48-72 hours minimum) for compensation

A

excretion of HCO3 by kidney

69
Q

ILD
chest wall disease
neuromuscular disease
opiate use

A

causes of primary respiratory acidosis

70
Q

how to compensate for respiratory acidosis

A

retain HCO3-

71
Q

respiratory compensation for metabolic acidosis— fast, but ____

A

incomplete

72
Q

metabolic compensation for respiratory acidosis—–slow, but ______

A

more complete

73
Q

inadequate tissue oxygen

A

hypoxia

74
Q

low arterial oxygen tension (PaO2)
less than 80 mmHg

A

hypoxemia

75
Q

low arterial oxygen saturation (SaO2)
less than 90%

A

desaturation

76
Q

will widen A-a gradient and lead to hypoxemia

A

low V/Q and shunt

77
Q

alveolar gas equation

A

PAO2= (Pb - PH2O) x FiO2 - PaCO2/R

78
Q

best estimate to low V/Q mismatch

A

P(A-a) gradient

79
Q

normal A-a gradient

A

10-12

80
Q

5 main causes of hypoxemia (PaO2<80 mmHg)

A

altitude
hypoventilation
diffusion
low V/Q mismatch
shunt

81
Q

extreme exercise or extreme altitude (doesn’t occur very often in clinical medicine)
as the blood passes through the capillary in the alveolar interface, there is not complete equilibration b/t alveoli and the blood going past it

A

diffusion as cause of hypoxemia

82
Q

normal A-a O2 gradient w/ hypoxemia

A

altitude
hypoventilation

83
Q

increased A-a gradient w/ hypoxemia

A

diffusion
low V/Q mismatch
shunt

84
Q

___ and ___ contribute to arterial hypoxemia

A

shunt and low V/Q

85
Q
A

shunt

86
Q
A

low V/Q

87
Q

responds to 100% oxygen

A

low V/Q (not shunt)

88
Q

How you get carboxyHb and methemoglobin

A

co-oximeter

89
Q

failure to excrete CO2

A

hypercapneic (ventilatory) respiratory failure

90
Q

inability to oxygenate

A

hypoxic respiratory failure

91
Q

minute ventilation decreased or dead space increased

A

respiratory failure

RES Biweekly 3 (11 decks)

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