Lecture - Acid Base, Organization of the CVS, Heart as a Pump Flashcards

1
Q

Difference between SYSTOLIC PRESSURE and DIASTOLIC PRESSURE?

A

PULSE PRESSURE

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2
Q

What is the buffering power of whole blood:

A

25 Mm/pH

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3
Q

Depletion of HCO3 limits the neautralization of –OH in what system?

A

Open system

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4
Q

What limit the neutralization of the hydroxide ion in the open system when you will add a strong base that is
sodium hydroxide?

A

BUILD UP OF BICARBONATE ION

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5
Q

Anxiety, expected metabolic imbalance?

A

RESPIRATORY ALKALOSIS

pt. is hyperventilating, blows off too much CO2: CO2 decreases, pH increases

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6
Q

What phase is the blowing or swishing sound in Korotkoff?

A

PHASE II

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7
Q

Period of Isovolumetric relaxation?

A

Phase 4

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8
Q

Which of the following is correctly matched:

A

SYSTOLE – Phase 2 and Phase 3

DIASTOLE – Phase 1 and Phase 4

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9
Q

Activity of valves at the end of Diastole?

A

CLOSING OF SEMILUNAR VALVES AND OPENING OF AV VALVES

ventricular relaxation

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10
Q

Actvity of the valves at the end of Systole?

A

OPENING OF SEMILUNAR VAVLVES AND CLOSING OF AV VALVES

(ventricular contraction; remember, blood is being pumped out from the LEFT VENTRICLE to the SYSTEMIC CIRCULATION (and Right Ventricle to the Pulmonary circulation)

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11
Q

NOT TRUE about FLOW in Poisuille’s equation?

A

DIRECTLY PROPORTIONAL TO VISCOSITY

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12
Q

Low compliance?

A

INCREASE IN PRESSURE and INCREASE IN BLOOD VOLUME

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13
Q

What is the body’s RESPONSE to DIARRHEA?

A

INCREASE IN VENTILATION (to produce respiratory alkalosis)

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14
Q

Miss R, severe vomiting (METABOLIC ALKALOSIS) due to an unknown cause leads to a primary acid-base
imbalance, what is the body’s response to this problem?

A

A. Kidneys secrete more acid in the urine (FALSE, kailangan ng body mo ang H+ kase alkalotic ang pt mo, dapat decrease ang excretion)
B. Transport more bicarbonate in the blood (FALSE, remember, your pt is already alkalotic so there’s no
need for more bicarbonate)
C. Increase in ventilation (FALSE, increasing ventilation will cause alkalosis. Para ma balance ang acid- base problem ng pt natin, we need to decrease ventilation to produce RESPIRATORY ACIDOSIS)
D. NONE OF THE ABOVE.

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15
Q

45 year-old female, with renal failure missed her dialysis (METABOLIC ACIDOSIS). Physician diagnosed
her with an acid-base disturbance, what could be the PRIMARY COMPENSATION in the body:

A

INCREASE IN VENTILATION (PRIMARY response for METABOLIC DISTURBANCE is RESPIRATORY and VICE-VERSA)

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16
Q
  1. What buffering power reaches MAXIMUM an pK?
A

Closed system

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17
Q
Pt. with neurodegenerative disorder with progressive muscle weakness, with ABG:
pH - 7.37
PCO2 - 57
PO2 - 70
HCO3- 32
A

REPIRATORY ACIDOSIS : METABOLIC ALAKALOSIS(compensation)

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18
Q

What is the PRIMARY ACID-BASE DISTURBANCE and what is its COMPENSATORY PROCESS?

A

RESPIRATORY ACIDOSIS : METABOLIC ALKALOSIS

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19
Q

Which of the following structures represents the conjugate acid?

A

DIHYDROGEN PHOSPHATE

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20
Q

Which among of the four types of compensation is considered the LEAST PERFECT?

A

RESPIRATORY ACIDOSIS

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21
Q

What solution will act rapidly and strongly to hydrogen ion?

A

STRONG BASE

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22
Q

During interaction of CO2 with H2O, at what part of the reaction does pH falls?

A

DISSOCIATION OF CARBONIC ACID

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23
Q

Identify which is NOT CORRECT.

A

GRADE 5 IS SO LOUD THAT IT CAN BE HEARD WITH STETH OFF THE CHEST ACCOMPANIED BY A THRILL

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24
Q

BERNOUILLE EFFECT

A

SAME HIGHER LOWER

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25
Q

Number 23 daw:

A

TRANSMURAL PRESSURE, INCREASE WHEN BLOOD FLOW VOLUME INCREASES

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26
Q

SA NODE Is the main pacemaker because?

A

ITS INTRINSIC RATE OF AUTOMATICITY IS HIGHER THAN THE OTHER CARDIAC PACEMAKERS

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27
Q

Longest delay in conduction of impulse to the cardiac muscle is at the?

A

AV node

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28
Q

Atrial depolarization is completed before ventricular depolarization starts mainly because?

A

THE CONDUCTION RATE IN AV NODE IS SLOW

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29
Q

Stroke volume is?

A

AMOUNT OF BLOOD EJECTED PER SYSTOLE (PER HEATBEAT/PER SECOND)

CARDIAC OUTPUT IS AMOUNT OF BLOOD EJECTED AFTER 1 MINUTE

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30
Q

The following events are part of your ventricular systole EXCEPT?

A

VENTRICULAR FILLING (ventricular filling takes place during ventricular diastole/relaxation)

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31
Q

The factors controlling cardiac output include all of the following EXCEPT:

A. Changes in heart rate
B. Existing afterload
C. Extent of atrial filling
D. Amount of available calcium ions

A

D. Amount of available calcium ions

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32
Q

The Frank-Starling’s law simple states that?

A

Within physiologic limit, the heart will pump all the blood regardless of the arterial pressure

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33
Q

In the Cardiac cycle, Phase 4 corresponds to?

A

Isovolumetric relaxation

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34
Q

Which valvular event correctly terminates its phase?

A

AV VALVE OPENING TERMINATES PHASE 4.

SEMILUNAR VALVE OPENING TERMINATES PHASE 2

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35
Q

What best defines the cardiac cycle?

A

Mechanical and electrical events repeating every heart rate.

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36
Q

With the following results decrease pH, increased H+, increase PCO2, increased bicarbonate. What is the acid-base disturbance?

A

Respiratory Acidosis

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37
Q

With the following results decreased pH, increased H+, decreased PCO2, decreased bicarbonate. What is the disturbance?

A

Metabolic Acidosis

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38
Q

Increased pH, decreased H+, decreased PCO2, decreased bicarbonate.

A

Respiratory Alkalosis

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39
Q

Increased pH, decreased H+, increased PCO2, increased bicarbonate.

A

Metabolic Alkalosis

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40
Q

Any chemical that can donate Hydrogen?

A

Acid

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41
Q

What is true of a buffer?

A

Minimize pH changes

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42
Q

What buffering power increases exponentially with pH?

A

Open System

43
Q

What buffering power reaches a maximum at pK?

A

Closed System

44
Q

All are true for renal handling of acids in metabolic acidosis, EXCEPT:

A

Bicarbonate reabsorption is decreased

45
Q

Which of the following is appropriate with for a female suffering of Insulin-dependent diabetes mellitus with pH of 7.2, bicarbonate of 17, pCO2 of 20?

A

Metabolic Acidosis

46
Q

Which of the following compounds most effective buffer system at physiological pH?

A

Bicarbonate

47
Q

45-year old female with renal failure missed her dialysis and feeling sick.

A

Metabolic Acidosis

48
Q

Student is nervous for a big exam and is breathing rapidly.

A

Respiratory Alkalosis

49
Q

Young woman is found comatose, having taken an unknown number of sleeping pills. Arterial blood sample yields pH = 6.9, HCO3 = 13, pCO2 = 68. Acid-base balance would be described as?

A

Simultaneous respiratory and metabolic acidosis

50
Q

Climber attempts on an assault on a high mountain that reaches to an altitude of 5000m above sea level, what will happen to his arterial PCO2 and pH?

A

pH will rise and PCO2 will fallo

51
Q

Hospital patient with AIDS has a large amount of diarrhea over the passed 24 hours. He becomes hypovolemic, which of the following lab results will best fit his clinical history?

A

pH = 7.25, pCO2 = 36, HCO3 = 15

52
Q

30-year old male with bronchiectasis presents in the hospital emergency room in 3 days increased in cough, sputum and dyspnea, despite maximizing bronchodilators. Patient vital signs are BP = 117/65, ABG = 7.28, pCO2 = 70, pO2 = 50, HCO3 = 23. Which of the following best characterizes the current acid-base balance?

A

Uncompensated Respiratory Acidosis

53
Q

What is the relationship of pH and hydrogen?

A

Inversely Proportional

54
Q

Which of the following does not play a significant role of maintaining the acid-base balance?

A

Stomach

55
Q

Purpose of a buffer system?

A

Maintain pH range

56
Q

In the bicarbonate buffer system, __________ reacts with bases.

A

Carbonic acids

57
Q

Which factor greatly increases the reaction between carbon dioxide and water?

A

Carbonic anhydrase

58
Q

During periods of acidosis, the kidney will secrete _______ into the urine.

A

H2PO4

59
Q

In an attempt to remove acid from blood, the kidneys will secrete __________ into the urine.

A

Ammonia

60
Q

Which mechanism requires the most time to regulate pH?

A

Renal Function

61
Q

What happens to the HCl in the phosphate buffer system reaction?

A

Forms a weak acid and salt

62
Q

P Wave

A

Atrial Depolarization

63
Q

QRS Complex

A

Ventricular Depolarization

64
Q

Conventional definition of bradycardia and tachycardia?

A

<60 bpm

>100 bpm

65
Q

If PR interval is affected by your sympathetic and parasympathetic systems for faster heart rates, what happens to PR interval?

A

Shortens

66
Q

When mitral valve adheres very closely to one another that it inhibits blood flow?

A

Mitral Stenosis

67
Q

Normal circulation from SVC and IVC enters heart thru

A

Right Atrium

68
Q

Action potential for action potentials such as SA node and AV node

A

Fast Upstroke

69
Q

Action potential of SA node characterized by

A

Slow Phase of Depolarization

70
Q

Mechanism of arrhythmia in third degree of AV block

A

Abnormal impulse production

71
Q

Most serious cardiac arrhythmia that can lead to death

A

Ventricular Fibrillation

72
Q

Period in cardiac cycle when valves open and there is rapid inflow of blood in heart

A

Rapid Filling

73
Q

Cardiac cycle: aortic and mitral valves are closed

A. Isovolumetric contraction
B. Isovolumetric relaxation
C. Both a and b

A

C. Both a and b

74
Q

Cardiac cycle: phase 4

A

Isovolumetric Relaxation

75
Q

Chamber enlarged in aortic stenosis

A

Left Ventricle

76
Q

Chamber enlarged in mitral stenosis

A

Left Atrium

77
Q

Normal cardiac cycle

A. First heart sound coincides with
ventricular ejection
B. Second heart sound coincides with
end of ventricular ejection
C. Highest left ventricular pressure is reached just as aortic valve closes
D. Atrial systole occurs during isovolumetric relaxation

A

B. Second heart sound coincides with end of ventricular ejection

78
Q

Amount of blood leaving the blood ventricles if you have 80mL, cardiac rate is 80bpm, pressure is 100mmHg

A

CO = 6.4

79
Q

True about Frank Starling Law

A

Greater muscle strength, greater muscle contraction

80
Q

Approximately how much blood flows thru the atria into the ventricles before atria contracts

A

70-80%

81
Q

When blood pressure in left ventricle exceeds that of the aorta, which of the following occurs?

A

Semilunar valves open

82
Q

Which of the following is true of acidosis?

A

Increase concentration of hydrogen

83
Q

Extreme removal of hydrogen ion from the body.

A

Alkalosis

84
Q

What substance that accepts protons:

A

Base

85
Q

Donor

A

Acid

86
Q

Decrease blood flow and hypoxia of tissues can cause the pH to:

A

Decrease

87
Q

Which regulates body fluid Hydrogen ion concentration by combination with acid base molecules:

A

Buffer

88
Q

What is the most important buffer system:

A

Bicarbonate

89
Q

Adding strong base to the solution produces a:

A

Weak base plus water

90
Q

Most of the buffering of the body occurs in the ECF:

A

False

91
Q

Increase in alveolar ventilation means to the ff except:

A

Decreased pH

92
Q

ABG finding is:
pH 7.1
Bicarbornate 20
PCO2 30

A

Metabolic acidosis

93
Q

ABG

pH - 7.4
PCO2 - Increased
Bicarbonate - Increased

A

Respiratory acidosis

94
Q

Severe vomiting:

A

metabolic alkalosis

95
Q

Severe diarrhea:

A

Loss of bicarbonate

96
Q

Which of the ff clinical causes leads to respiratory alkalosis:

A

Anxiety

97
Q

Absence of buffers, bicarb of 48 mmhg:

A

pH - 7.7

98
Q

In the presence of co2 hc03 buffer the pco2 of 80 mmhg can cause the:

A

pH 7.1

99
Q

The enzyme carbonic anhydrase present in the erythrocytes and elsewhere catalyzes this slow reaction:

A

Hydrogen ion and bicarbonate

100
Q

Which statement regarding acid base physiology is not true accdg to Henderson-hasselbach equation

A

pH depends on the ratio of bicarbonate and CO2

101
Q

Which of the following ion transporters in the plasma membrane tends to acidify the cell as long as this transporter is active:

A

Cl-HCO3 loader

102
Q

Which of the following happens in extracellular acidosis:

A

hyperK, release of K+ in the cell, K+ uptake…

103
Q

Extracellular respiratory acidosis.. affects intracellular ph in 3 phases:

A

phase 1 moves co2 inward