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elimination and detox - wk 3 > intro to acid base physiology > Flashcards

intro to acid base physiology Flashcards

1
Q

what is the normal pH of the body

A

7.4
(7.35 - 7.45)

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2
Q

acidemia pH and alkalemia pH?

A
  • acidemia: pH < 7.35
  • alkalemia: pH > 7.45
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3
Q

the acid-base balance is tightly regulated by two main systems:

A
  • respiratory
  • metabolic
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4
Q

respiratory acid-base

A
  • CO2 is acidic
  • is pCO2 increases, pH drops
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5
Q

what controls the partial pressure of CO2 in the blood

A

lung ventilation

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6
Q

metabolic acid-base

A
  • HCO3- is alkaline
  • if HCO3- increase, pH increase
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7
Q

what controls the amount of bicarbonate in the blood

A

kidney

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8
Q

what is the normal PCO2 in the arterial blood and venous blood

A

40 mmHg; 46 mmHg

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9
Q

what is pCO2

A

partial pressure of CO2 gas dissolved in the plasma

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10
Q

how is pCO2 measured

A
  • blood gas analysis
  • can be venous (PvCO2) or arterial (PaCO2)
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11
Q

what is ventilation

A

how much air is being moved by the lungs

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12
Q

hypoventilation

A
  • too much CO2 is retained (not breathed off)
  • pCO2 increases
  • pH drops
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13
Q

hyperventilation

A
  • too much CO2 is expelled
  • pCO2 decreases
  • pH rises
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14
Q

pCO2 can change quickly or slowly?

A

quick (within seconds or minutes)

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15
Q

what is the only cause of increase pCO2

A

hypoventilation

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16
Q

hypoventilation problems

A
  • brain problem (anesthesia, brain disease)
  • diaphragm problem
  • blocked airways
17
Q

hyperventilation problems

A
  • fear or pain
  • hypoexmia
  • acidemia
18
Q

respiratory acidosis

A

pCO2 is HIGH

“hypercapnic from hypoventilation”

19
Q

respiratory alkalosis

A

pCO2 is LOW

“hypocapnic from hyperventilation”

20
Q

name the acid base abnormality for a patient with a:

  • PaCO2 - 71 mmHg
  • PaCO2 - 28 mmHg
  • PvCO2 - 40 mmHg
A
  • respiratory acidosis (hypoventilation)
  • respiratory alkalosis (hyperventilation)
  • normal
21
Q

what does HCO3- indicate and how can it be measured

A
  • the amount of bicarbonate anion in the plasma
  • measured on blood gas or serum chem analysis (called TCO2)
22
Q

HCO3- changes slowly or quickly?

A

slowly (days)

22
Q

HCO3- changes slowly or quickly?

A

slowly (days)

23
Q

what are the two mechanisms for metabolic alkalosis

A
  • kidney retains too much bicarb
  • chloride loss from upper GI (vomiting, pyloric obstuction)
24
Q

what are the 3 mechanisms for metabolic acidosis

A
  • the kidney loses too much bicarb
  • the colon can lose bicarb from lower GI via diarrhea
  • you accumulate “poison anions” in your blood
25
Q

metabolic acidosis

A

HCO3- is LOW

26
Q

metabolic alkalosis

A

HCO3- is HIGH

27
Q

what is the normal HCO3-

A

~24 mg/dL

28
Q

name the acid base abnormality for a patient with a:

  • HCO3 - 26 mg/dL
  • TCO2 - 45 mg/dL
  • HCO3 - 24 mg/dL
  • TCO2 - 11 mg/dL
A
  • metabolic alkalosis
  • metabolic alkalosis
  • normal
  • metabolic acidosis
29
Q

what is the HCO3- equation

A

H2O + CO2 <-> H2CO3 <-> H+ + HCO3-

30
Q

what is base excess

A

the amount of HCl or HCO3- required to return 1L of blood (at 38 deg. C with a standardized PCO2 and Hb) to a pH of 7.40

31
Q

what are the 4 main derangements of pH in the blood

A
  • respiratory acidosis and alkalosis
  • metabolic acidosis and alkalosis
32
Q

what is the anion gap

A

measure many plasma anions (chloride) but in some diseases or intoxications, unmeasured anions can build up

33
Q

what is the anion gap equation

A

([Na+] + [K+]) - ([Cl-] + [HCO3-])

34
Q

an excess of unmeasured anions causes a high ____ ____, this makes the bicarbonate decrease, leading to a:

A

anion gap; metabolic acidosis

35
Q

what might be causing a high anion gap

“find the poison anion”

A

K.L.U.E

(ketone, lactate, uremic toxin, ethylene glycol)

36
Q

what are the two flavors or metabolic acidosis

A
  • Normal anion gap metabolic acidosis (NAGMA) (kidney problem)
  • High anion gap metabolic acidosis (HAGMA) (poison anion problem)
37
Q
  • pH - 7.134
  • pH - 7.51
  • pH - 6.91
  • pH - 7.4
  • pH - 7.93
  • pH - 7.39
A
  • acidmia
  • alkalemia
  • acidemia
  • normal
  • alkalemia
  • normal
38
Q

compensatory acidois/alkalosis

A

if a patient has an acid-base abormality it will compensate normalaize pH

elimination and detox - wk 3 (6 decks)

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