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Pathophysiology 2 > Introduction to Acid-base balance > Flashcards

Introduction to Acid-base balance Flashcards

1
Q

Acid

A

A substance that can donate H+ (and has a high concentration of H+)

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2
Q

Base

A

A substance that can accept a H+ (low H+ concentration)

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3
Q

As H+ increases

A

pH decreases by a log of 10

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4
Q

As H+ decreases

A

pH increases by a log of 10

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5
Q

What is the normal blood pH

A

7.35-7.45

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6
Q

Acidemia

A

Increase in H+ means a low pH (

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7
Q

Alkalemia

A

Decrease in H+, means a high pH (>7.40)

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8
Q

Acidosis

A

Process which increases plasma H+

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9
Q

Alkalosis

A

Process which decrease plasma H+

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10
Q

How does the body regulate (balance) acids and bases

A
  1. Chemical buffer system
  2. Respiratory buffer systems
  3. Liver oxidation of strong acids
  4. Renal mechanisms
    (Goes in this order)
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11
Q

Chemical buffer system

A
  1. phosphate (IC)
  2. protein (hemoglobin, amino acids, plasma proteins)
  3. HCO3 (carbonic acid becomes bicarb)
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12
Q

Respiratory buffer system

A

Retain or blow off CO2 depending on whether it is an acidosis or alkalosis problem

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13
Q

What part of the brain controls the respiratory buffer system

A

Brainstem (acts within 1-3mins)

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14
Q

What happens to respirations when there is a rise in H+ (metabolic acidosis)

A

Deep, rapid breathing, expels CO2 which causes H+ to be reduced

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15
Q

What happens to respirations when there is a decrease in H+ (metabolic alkalosis)

A

Slower, shallow breathing, expels less CO2, which causes H+ to be increased

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16
Q

Kidney role in H+ maintenance

A

ONLY the kidneys can get rid of non-volatile acids (lactic, uric, phosphoric) via H+, HCO3 excretion or reusing of the H+ (NH4)

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17
Q

What is the ultimate acid-base regulatory organ

A

Kidney

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18
Q

Most important renal mechanism for regulating HCO3

A
  1. Reabsorbs HCO3 and generates new HCO3

2. Excretes HCO3

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19
Q

What does reabsorption of HCO3 defend agains

A

Acidosis

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20
Q

What does excretion of HCO3 defend against

A

Alkalosis

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21
Q

ABG

A

Arterial blood gas. Measures pH, pCO2, pO2 Calculates HCO3

22
Q

pH=

A

HCO3/pCO2

23
Q

What is the usefulness of the ABG

A

Determining if a patient has metabolic/respiratory acidosis or alkalosis

24
Q

What is the normal pCO2

A

38-42

25
Q

What is the normal HCO3

A

24 (22-26)

26
Q

Anion gap

A

The difference in measured cations (+) and measured anions (-). Can measure in serum, plasma, or urine

27
Q

Normal AG

A

12 (+/-2)

28
Q

Actual AG equation

A

Na+ - (Cl- + HCO3-)… Cations minus anions

29
Q

What is the diagnosis if you have a high AG

A

metabolic acidosis

30
Q

1st step in acid-base disorders

A

Consider clinical setting (anticipate the disorder)

31
Q

2nd step in acid-base disorders

A

Is the patient academic or alkalemic

32
Q

3rd step in acid-base disorders

A

Is the process metabolic or respiratory

33
Q

4th step in acid-base disorders

A

If metabolic acidosis, is there an anion gap or not

34
Q

5th step in acid-base disorders

A

Is compensation appropriate (use formulas)

35
Q

6th step in acid-base disorders

A

Is there more than one disorder present, use the change in formulas

36
Q

If it is a metabolic problem

A

The lungs will try and compensate

37
Q

If it is a respiratory problem

A

the kidneys will try and compensate

38
Q

What 2 things do you look for in order to determine if it is metabolic

A

HCO3 and pCO2 lab values should go in the same direction

39
Q

Respiratory alkalosis

A

Hyperventilation, causes decrease in pCO2, which increases pH

40
Q

Signs of respiratory alkalosis

A

Dizziness, light headed, confusion (pts on ventilators)

41
Q

Lab findings of respiratory alkalosis

A 
pH = increase
pCO2 = decrease
HCO3 = decrease (renal compensation)
42
Q

Respiratory acidosis

A

Hypoventilation, causes an increase in pCO2, which decreases pH

43
Q

Signs/causes of respiratory acidosis

A

Upper airway obstruction, SOB, headache, blurred vision

44
Q

Lab finding of respiratory acidosis

A

pH = decrease
pCO2 = increase
HCO3 = increase
(renal compensation

45
Q

Metabolic alkalosis

A

Too much OH-, very little H+

46
Q

Signs/causes of metabolic alkalosis

A

Loss of H+, or retention of bicarbonate. Slow, shallow breathing

47
Q

Lab finding of metabolic alkalosis

A

pH = increase
pCO2 = increase
HCO3 = increase
(respiratory compensation)

48
Q

Metabolic acidosis

A

Too much H+, very little OH-

49
Q

Signs/causes of metabolic acidosis

A

Kidney cannot clear the H+ or too much H+ generation. Deep, rapid breathing

50
Q

Lab finding of metabolic acidosis

A 
pH= decrease
pCO2 = decrease
HCO3 = decrease
51
Q

Mixed/compensatory acid/base

A

More than one acid-base disorder occurring simultaneously. You will see pCO2 and HCO3 in opposite directions

Pathophysiology 2 (8 decks)

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