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CC II (lec) > M3: Blood Gases and Acid-Base Balance > Flashcards

M3: Blood Gases and Acid-Base Balance Flashcards

1
Q

substances that donates hydrogen ions
(H+) when dissolved in water

A

Acid

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2
Q

Has a sour taste

A

Acid

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3
Q

substances that accepts hydrogen ions
(H+)

A

Base

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4
Q

has a bitter taste

A

Base

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5
Q

negative logarithm of hydrogen ion
concentration

A

pH

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6
Q

Strength of hydrogen ion present in a
substance

A

pH

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7
Q

a system or substance that resist
changes in pH upon adding acid or base

A

Buffer

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8
Q

Buffer contains what:

A

weak acid and salts of conjugate base

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9
Q

Most common and important buffer in the
body:

A

H2CO3 or carbonic acid and
HCO3- or bicarbonate

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10
Q

T/F: carbonic acid is a weak acid

A

T

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11
Q

T/F: bicarbonate is a salts of conjugate base

A

T

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12
Q

According to Brønsted–Lowry Theory of Acid and Bases,
Acids (H) + Bases (OH) will result to what?

A

Water (H2O)

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13
Q

In this theory, acid donates hydrogen ions to the Base
(hydroxyl ion), while the Base accepts the hydrogen ions

A

Brønsted–Lowry Theory of Acid and Bases

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14
Q

Hydrogen Ion Concentration is maintained at ___

A

36-44 nmol/L

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15
Q

Hydrogen Ion Concentration maintained at 36-44 nmol/L is equivalent to ____

A

normal blood pH

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16
Q

↑H+ = _____ (inc/dec) acidity of the substance

A

↑acidity of the substance

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17
Q

Body naturally produced hydrogen ions
approx. ____

A

150g H+/day

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18
Q

T/F: Body naturally produced hydrogen ions
approx. 150g H+/day but maintained at
36-44 nmol/L

A

T

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19
Q

What is the blood pH

A

7.35-7.45 (7.40)

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20
Q

Blood pH is _____ (in chemistry) but
_____ (physiologically)

A

slightly alkaline

neutral

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21
Q

Process that causes acidemia/alkalemia:

A

Acidosis
Alkalosis

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22
Q

<7.35 blood pH

A

Acidosis

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23
Q

> 7.45 blood pH

A

Alkalosis

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24
Q

Acidosis causes ____, which is the acidic pH of the blood

A

acidemia

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25
Q

Alkalosis causes ____, which is the basic pH of the blood

A

alkalemia

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26
Q

Control Centers of the Acid-Base Balance

A

→ Buffer Systems
→ Lungs:
→ Kidneys:

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27
Q

controls carbon dioxide

A

Lungs:

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28
Q

acidic component of the blood

A

carbon dioxide

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29
Q

↑ CO2 = _____ (acidic/basic)
↓ CO2 = _____(acidic/basic)

A

acidic;
basic

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30
Q

controls bicarbonate

A

Kidneys

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31
Q

alkaline component of the blood

A

bicarbonate

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32
Q

↑ HCO3 - = ____(acidic/basic)
↓ HCO3 = ____(acidic/basic)

A

basic;
acidic

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33
Q

What are the 4 buffer systems

A
  1. Bicarbonate-Carbonic Acid Buffer System
  2. Protein Buffer System
  3. Phosphate Buffer System
  4. Hemoglobin Buffer System
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34
Q

Most important blood buffer system

A

Bicarbonate-Carbonic Acid Buffer System

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35
Q

Utilized HCO3- (conjugate base) and H2CO3
(weak acid) to minimize pH changes

A

Bicarbonate-Carbonic Acid Buffer System

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36
Q

Bicarbonate-Carbonic Acid Buffer System:

Blood pH of ____ is equivalent to the ratio of
_____

A

7.40
HCO3- : H2CO3

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37
Q

What is the ratio of HCO3- : H2CO3 in Bicarbonate-Carbonic Acid Buffer System

A

(20:1)

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38
Q

Uses plasma proteins to minimize pH changes

A

Protein Buffer System

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39
Q

In protein Buffer System, Majority of proteins are _______

A

negatively charged

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40
Q

T/F: Negatively charged proteins are Capable of binding positively charged substance

A

T

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41
Q

determines the pH or
the acidity of the substance

A

hydrogen ion (H+)

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42
Q

T/F hydrogen ion (H+) is a cation

A

T

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43
Q

↑H+ = ___ (acidic/alkaline)
↓H+ = ____(acidic/alkaline)

A

acidic;
alkaline

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44
Q

T/F: If protein can bind hydrogen, it can maintain
pH

A

T

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45
Q

If protein can bind ___, it can maintain ___

A

hydrogen; pH

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46
Q

The primary buffer in urine

A

Phosphate Buffer System

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47
Q

Utilizes HPO4- (phosphates) and H2PO4
(phosphoric acid)

A

Phosphate Buffer System

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48
Q

Plays a role in buffering CO2 during transport to
the lungs

A

Hemoglobin Buffer System

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49
Q

Three phases of Bicarbonate-Carbonic Acid Buffer System

A
  1. Peripheral Tissue (Cells)
  2. Circulation (Inside the RBC)
  3. Lungs
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50
Q

PERIPHERAL TISSUE: (CELLS)

● When cells undergo _______ , they
produced _____

A

aerobic metabolism;
CO2

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51
Q

biochemical process in
the body that utilizes oxygen

A

Aerobic metabolism

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52
Q

PERIPHERAL TISSUE: (CELLS)

What are the two phases of CO2

A
  • Small amount of CO2 will bind to the amino
    group of protein forming carbamino
    compounds

-Majority of CO2 diffuses into RBC (enters)

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53
Q

PERIPHERAL TISSUE: (CELLS)

2 phases of CO2:
→ Small amount of CO2 will bind to the ____of protein forming _____
→ Majority of CO2 ____ into ____C (enters)

A

→ amino group; carbamino compounds
→ diffuses; RBC

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54
Q

CIRCULATION (INSIDE THE RBC):

In the circulation, the CO2 will bind to the
_____ forming _____ by the
action of the enzyme ______.

A

intracellular H2O;
carbonic acid;
carbonic anhydrase

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55
Q

CIRCULATION (INSIDE THE RBC):

This enzyme will split the carbonic acid into
____ and _____

A

Carbonic anhydrase;
bicarbonate;
hydrogen ions

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56
Q

CIRCULATION (INSIDE THE RBC):

→ The hydrogen ions will _____ the pH,
therefore, _____ the ______ inside the
RBC

A

decrease
increasing
acidity

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57
Q

CIRCULATION (INSIDE THE RBC):

In order for the pH to be neutralize,
the hydrogen will be bound to
_____

A

Hbg (HHb)

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58
Q

regarded as HHb

A

DeoxyHbg

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59
Q

Why is DeoxyHbg regarded as HHb

A

because this is a hemoglobin that
contain hydrogen ion and not
oxygen (Hemoglobin Buffer system)

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60
Q

CIRCULATION (INSIDE THE RBC)

The bicarbonate will ________ of the cell
and will go to the ___.

A

diffuse out;
plasma

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61
Q

T/F: bicarbonate will not disturb
electroneutrality

A

F; it will disturb electroneutrality

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62
Q

Why bicarbonate will disturb electroneutrality

A

Since bicarbonate is a negatively
charged electrolyte, it will disturb
electroneutrality (there will be an
accumulation of negatively charged in
the plasma)

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63
Q

CIRCULATION (INSIDE THE RBC):

In order to maintain electroneutrality,
____ needs to ___ the ___ (chloride shift)

A

chloride;
enter;
RBC

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64
Q

chloride shift aka

A

hamburger shift

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65
Q

IN THE LUNGS:

The inhaled ____ will ___ from the ___ to
the ____ which will bind to _____

A

oxygen;
diffuse;
alveoli;
circulation;
deoxygenated hemoglobin (HHb)

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66
Q

IN THE LUNGS:

When the HHb binds to the oxygen it will form
_______

A

oxygenated hemoglobin

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67
Q

IN THE LUNGS:

The HHb release ___ to form _____. The ___ from the inside
of RBC will ___ the RBC.

A

H+;
oxygenated hemoglobin;
hydrogen;
exit

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68
Q

IN THE LUNGS:

The bicarbonate in the ____ (phase 2) will bind
to the ___ that is released from the binding
of ____ and ____ , forming
_____ which is then split into _____ and
____.

A

plasma;
hydrogen;
deoxyhemoglobin;
oxygen;
carbonic acid;
water AND carbon dioxide

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69
Q

IN THE LUNGS:

The ____ will ____ from the ____ and will
be eliminated through ____ or _____.

A

CO2;
diffuse out;
alveoli;
exhalation or ventilation

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70
Q

Importance of Bicarbonate-Carbonic Acid Buffer System

  1. _____ dissociates into ____ and ____, allowing CO2 to be eliminated by the ____and H+ as ____.
  2. Changes in CO2 modify the _______ (____)
  3. ____ concentration can be altered by the
    ____
A
  1. H2CO3; CO2; H2O; lungs; water
  2. respiratory rate (ventilation)
  3. HCO3- kidneys
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71
Q

What are the three importance of Bicarbonate-Carbonic Acid Buffer System

A
  1. H2CO3 dissociates into CO2 and H2O, allowing CO2
    to be eliminated by the lungs and H+ as water.
  2. Changes in CO2 modify the respiratory rate (ventilation)
  3. HCO3- concentration can be altered by the kidneys
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72
Q

Acid base balance by the bicarbonate-carbonic
acid buffer system is mediated by the two
organs: ____ and ____

A

lungs and kidneys

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73
Q

It expresses acid-base relationship and relates
the pH of a solution to the dissociation properties
of weak acid

A

HENDERSON-HASSELBACH EQUATION

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74
Q

What is the formula of HENDERSON-HASSELBACH EQUATION

A

refer to your notes hehe

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75
Q

dissociation/ionization constant

A

pKa

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76
Q

ability of an acid/base to dissociate in water

A

pKa

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77
Q

T/F: Carbonic acid is directly measured in the
laboratory

A

F; NOT directly measured

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78
Q

T/F: Since Carbonic acid is NOT directly measured in the
laboratory. What is then measured ?

A

pCO2

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79
Q

What is pCO2

A

(partial pressure of carbon dioxide

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80
Q

partial pressure of carbon dioxide

A

pCO2

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81
Q

Majority of CO2 in the blood are in the form of
______. Hence, by measuring _____ we
can relate it to the amount of carbonic acid
present in the ____.

____ = ____ x ____

A

carbonic acid;
pCO2;
blood

𝐻2𝐶𝑂3 = 𝑝𝐶𝑂2 𝑥 0. 0307 𝑚𝑚𝑜𝑙/L

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82
Q

What is the solubility constant of pCO2

A

0.0307 mmol/L

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83
Q

pKa at physiologic temp./37°C

A

6.1

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84
Q

Compute for the blood pH of a healthy individual
with normal lungs and kidneys has the following
blood gas values:
→ HCO3-: 24 mmol/L
→ pCO2: 40 mmHg

A

refer to your notes

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85
Q

WHAT ARE THE TWO ORGANS THAT MAINTAIN ACID BASE BALANCE

A

Lungs and Kidney

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86
Q

Regulates CO2 excretion

A

Lungs

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87
Q

acid component

A

CO2

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88
Q

Conditions assoc. with acid-base balance by the
lungs is termed “____”

A

“Respiratory”

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89
Q

CO2 is measured in the laboratory as ____

A

pCO2

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90
Q

LUNGS:

Reference value (pCO2):

A

35-45 mmHg
(equivalent to pH: 7.35-7.45)

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91
Q

Blood is acidic (acidemia) due to the problem
with the lungs

A

Respiratory Acidosis

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92
Q

Respiratory Acidosis:

___ CO2 excretion = ____ CO2 in the blood = _____ pH

A

↓CO2 excretion = ↑CO2 in the blood = ↓ pH

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93
Q

Example of Respiratory Acidosis

A

hypoventilation

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94
Q

Alkalemia due to the problem with the lungs

A

Respiratory Alkalosis

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95
Q

Respiratory Alkalosis:

___ CO2 excretion = ____ CO2 in the blood = ___ pH

A

↑CO2 excretion = ↓CO2 in the blood = ↑pH

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96
Q

Example of Respiratory Alkalosis

A

hyperventilation

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97
Q

Regulates HCO3- excretion and reabsorption

A

Kidneys

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98
Q

alkaline component of the blood

A

HCO3-

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99
Q

Conditions assoc. with acid-base balance by the
kidneys are termed “______”

A

Metabolic

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100
Q

KIDNEYS:

Reference value (HCO3-): ____

A

22-29 mEq/L

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101
Q

KIDNEYS:

<22 mEq/L = ____ (acidic/alkaline)
>29 mEq/L = ____(acidic/alkaline)

A

acidic

alkaline

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102
Q

T/F: mEq/L and mmol/L are insignificant in terms of
____ because the conversion factor is ____

A

T; bicarbonate; 1

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103
Q

→ ↑HCO3- excretion = ↓pH = ↓HCO3- in the blood

A

Metabolic acidosis

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104
Q

In Metabolic acidosis:

____ HCO3- excretion = ____ pH = ____ HCO3- in the blood

A

↑HCO3- excretion = ↓pH = ↓HCO3- in the blood

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105
Q

Acidemia (<22)

A

Metabolic acidosis

106
Q

Metabolic acidosis is <22 (__)

A

Acidemia

107
Q

↓HCO3- excretion = ↑pH = ↑HCO3- in the blood

A

Metabolic alkalosis

108
Q

Alkalemia (>29)

A

Metabolic alkalosis

109
Q

Metabolic alkalosis = >29 =

A

Alkalemia

110
Q

T/F Bicarbonates are normally filtered by the
glomerulus.

A

F; NOT normally filtered

111
Q

In the _____, the unfiltered bicarbonate will bind to the ____
forming _____ which will further split
to ____ and ____ by _____enzyme

A

proximal tubule;
hydrogen;
carbonic acid;
water and carbon dioxide ;
carbonic anhydrase

112
Q

The ____ that is synthesized, will be
___ by the ____.

Inside the cell, it
will bind with the ______ forming
____ which are split into ____
and _____.

A

CO2;
reabsorbed;
PCT cells;
intracellular water;
carbonic acid;
hydrogen and bicarbonate.

113
Q

The bicarbonate will bind to____ and they will be ____ of the cell.

A

intracellular sodium;
diffused out

114
Q

T/F: The exit of sodium from PCT to the
bloodstream, necessitates the entry of
hydrogen

A

T

115
Q

T/F: From the split of carbonic acid, the hydrogen
will be diffused out of the cell to the proximal tubule to look for bicarbonate so that the bicarbonate can be reabsorbed.

A

T

116
Q

(↓ pH) = ____ pCO2
(↑ pH) = ____pCO2

(↓ pH) = ____(HCO3-)
(↑ pH) = ____(HCO3-)

A

↑, ↓ (opposite to the pH)

↓, ↑ (equal yung

116
Q

(↓ pH) = ____ pCO2
(↑ pH) = ____pCO2

(↓ pH) = ____(HCO3-)
(↑ pH) = ____(HCO3-)

A

↑, ↓ (opposite yung pCO2 sa pH)

↓, ↑ (equal yung HCO3- sa pH)

117
Q

ROME

A

R (lungs) Opposite

M (kidneys) Equal

118
Q

acts against disturbances in the acid base balance:

A

COMPENSATION MECHANISM

119
Q

Compensation in metabolic (kidneys)

A

Lungs

120
Q

Fast action; 1-2 days but very short
term compensation

A

Lungs

121
Q

Lungs acts fast about _____ but very ____

A

1-2 days;
short term compensation

122
Q

In METABOLIC:

Hyperventilation = ____ pCO2
Hypoventilation = ____ pCO2

A

↓pCO2

↑pCO2

123
Q

Compensation in Respiratory

A

KIDNEYS

124
Q

Slow action; 2-4 days but complete compensation

A

Kidneys

125
Q

Kidneys:

Slow action about _____ (up to ___)
but _____ compensation

A

2-4 days
up to 5 days
complete

126
Q

Respiratory:

↑HCO3- = ________
↓HCO3- = ________

A

↑HCO3- = Increase Renal HCO3- reabsorption
↓HCO3- = Decreased Renal HCO3- reabsorption

127
Q

Problem in the Kidneys with ↓pH

A

Metabolic Acidosis

128
Q

Bicarbonate deficiency (↓HCO3-)

A

Metabolic Acidosis

129
Q

Metabolic Acidosis is seen in:

A
  • Diabetic ketoacidosis
  • Lactic acidosis
  • Renal tubular acidosis
  • Diarrhea
  • Ammonium chloride, Calcium chloride,
    salicylates, ethanol
130
Q

Metabolic Acidosis:

↑Acetoacetic acid
and β-hydroxybutyric acid in Diabetic ketoacidosis will ____ pH

A

↓

131
Q

What increases in Diabetic ketoacidosis

A

↑Acetoacetic acid and β-hydroxybutyric acid

132
Q

Metabolic Acidosis:

what increases in Lactic acidosis that causes a decrease in pH

A

↑lactic acid

133
Q

CONDITION wherein the kidney cannot
reabsorb bicarbonate;

____ HCO3- excretion =↓pH

A

Renal tubular acidosis
↑

134
Q

T/F: Blood is acidic because of the excretion
of alkaline component therefore urine is
alkaline

A

T

135
Q

T/F urine is alkaline

A

T

136
Q

Metabolic Acidosis :

Diarrhea -> _______ = ↓pH

A

↑HCO3- loss

137
Q

Metabolic Acidosis :

Diarrhea -> _______ = ↓pH

A

↑HCO3- loss

138
Q

acid producing substance

A

Ammonium chloride, Calcium chloride,
salicylates, ethanol

139
Q

T/F: acid producing substance, such as Ammonium chloride, Calcium chloride, salicylates, ethanol decreases pH

A

T

140
Q

Electrolyte Imbalance IN Metabolic Acidosis

A

Hyperkalemia (↑K+), hyperchloremia (↑Cl-)

141
Q

What is the organ that compensates in Metabolic acidosis

A

Lungs

142
Q

Compensation in Metabolic Acidosis

A

Hyperventilation

143
Q

Hyperventilation ___ (inc/dec) respiratory rate

A

↑respiratory rate

144
Q

Compensation in Metabolic Acidosis:

To normalize the pH, lungs will _____ by
eliminating ____

A

↓pCO2
CO2

145
Q

Compensation in Metabolic Acidosis:

For every ______ = _____

A

For every ↓1 mEq/L HCO3- = ↓1-1.3 mmHg pCO2

146
Q

The problem is in the lungs with ↓pH

A

Respiratory Acidosis

147
Q

Excess CO2 accumulation (↑CO2)

A

Respiratory Acidosis

148
Q

Respiratory Acidosis is seen in:

A

→ Chronic Obstructive Pulmonary Disease
→ Drug
→ Congestive heart failure
→ Myasthenia gravis, CNS disease, botulism,
stroke, myxedema, pneumonia

149
Q
  • results to hypercarbia
A

Chronic Obstructive Pulmonary Disease
(COPD)

150
Q

(↑CO2) is a condition called

A

hypercarbia

151
Q

What are the drugs that can cause hypoventilation

A

morphines, barbiturates, alcohol

152
Q

Morphines and barbiturates are known
as ____

A

relaxants

153
Q

Hypoventilation: _____ CO2 excretion = _____ CO2 = ____pH

A

Hypoventilation: ↓CO2 excretion = ↑CO2 = ↓pH

154
Q

In Congestive heart failure, there is = ___

A

↓cardiac output

155
Q

Compensation organ in Respiratory Acidosis

A

kidney

156
Q

Compensation in Respiratory Acidosis

A

Retention of HCO3-

157
Q

What happens in the Compensation of Respiratory Acidosis

A

The kidney will retain bicarbonate (very slow;
completed within 5 days)

158
Q

In the compensation of respiratory acidosis, The kidney will retain bicarbonate. The compensation is very slow and will be completed within ___ days. But within 3 days it is ___ complete

A

5 days
90%

159
Q

In the compensation in respiratory acidosis:

↑ ____ mmHg pCO2 = ↑ ____ mEq/L HCO3-

A

↑ 10 mmHg pCO2 = ↑ 1 mEq/L HCO3-

160
Q

Problem in the kidney
↑pH

A

Metabolic Alkalosis

161
Q

↑pH = ___HCO3

A

↑

162
Q

Bicarbonate excess

A

Metabolic Alkalosis

163
Q

Metabolic Alkalosis is seen in

A

Vomiting
Sodium bicarbonate excess
Sodium lactate, citrate, acetate

164
Q

What happens in vomiting that causes an increased in ↑HCO3-

A

↑acid & Cl- loss = ↑HCO3-

165
Q

What are the HCO3- producing salts

A

→ Sodium lactate, citrate, acetate

166
Q

Metabolic Alkalosis:

Electrolyte imbalance: ____, ____

A

Hypokalemia,
Hypochloremia

167
Q

Organ that compensates in Metabolic Alkalosis

A

lungs

168
Q

Metabolic Alkalosis:

Compensation: ___

A

Hypoventilation

169
Q

Metabolic Alkalosis:

hypoventilation

A

↓respiratory rate = ↓CO2 loss = ↑pCO2 =
↓pH

169
Q

Metabolic Alkalosis:

hypoventilation:
↓respiratory rate = ____CO2 loss = ___ pCO2 = ____pH

A

↓respiratory rate = ↓CO2 loss = ↑pCO2 = ↓pH

170
Q

Least effective compensation mechanism

A

Hypoventilation

171
Q

Why is Hypoventilation Least effective compensation mechanism

A

because ↓respiratory rate results to ↓CO2
loss and ↓oxygen (hypoxemia)

172
Q

Hypoxemia stimulates ____

A

Hyperventilation

173
Q

Hyperventilation

___ CO2 loss = ____ pCO2 = ____ pH

A

↑CO2 loss = ↓pCO2 = ↑pH

174
Q

Problem is in the lungs
↑pH

A

Respiratory Alkalosis

175
Q

↑pH = ____ pCO2

A

↓

176
Q

Excess CO2 loss

A

Respiratory Alkalosis

177
Q

Respiratory Alkalosis is seen in

A
  • Hypoxemia, hysteria, anxiety
  • Drugs
  • Pulmonary emboli, pulmonary fibrosis
  • Progesterone
  • Hepatic cirrhosis, gram-negative sepsis
178
Q

results to hyperventilation

A

Hypoxemia, hysteria, anxiety

179
Q

↑CO2 loss

A

hyperventilation

180
Q

Example of drugs in Respiratory Alkalosis

A

aspirins, salicylates, nicotine

181
Q

chemical stimulants; stimulates the lungs resulting to
hyperventilation

A

aspirins, salicylates

182
Q

results to impairment of O2 exchange in the
lungs

A

Pulmonary emboli, pulmonary fibrosis

183
Q

cause of
chronic respiratory alkalosis in pregnant
women

A

↑progesterone

184
Q

Respiratory Alkalosis:

Electrolyte Imbalance: ___

A

Hypokalemia

185
Q

Organ that compensates in Respiratory Alkalosis

A

kidneys

186
Q

Respiratory Alkalosis:

Compensation (kidneys): ____

A

Increased HCO3- excretion

187
Q

Increased HCO3- excretion in the Respiratory alkalosis reduces ___

A

alkalinity

188
Q

Respiratory Alkalosis:

the compensation for bicarbonate: ___

A

↓1 mmHg pCO2 = ↓2 mEq/L HCO3-

189
Q

Two or more primary acid-base disorders coexist.

A

Mixed Acid-Base Disorder

190
Q

Result of inappropriate compensation

A

Mixed Acid-Base Disorder

191
Q

In mixed acid-base disorder, pCO2 and HCO3- are in ____

A

opposite direction

192
Q

Mixed Acid-Base Disorder:

○ Acidosis = ____pCO2 & ____HCO3
○ Alkalosis = ____pCO2 & ____HCO3

A

○ Acidosis = ↑pCO2 & ↓HCO3
○ Alkalosis = ↓pCO2 & ↑HCO3

193
Q

EVALUATION OF COMPENSATION:

Acidosis or Alkalosis; pCO2 or HCO3- is normal (the other one is
abnormal)

A

Uncompensated

194
Q

EVALUATION OF COMPENSATION:

Acidosis or Alkalosis; pCO2 and HCO3- are both abnormal

A

Partially Compensated

195
Q

EVALUATION OF COMPENSATION:

● Normal pH
● pCO2 and HCO3- are both abnormal

A

Compensated / Fully-compensated

196
Q

REFERENCE VALUES:

pH: __
pCO2:__
HCO3-:___

A

pH: 7.35-7.45
pCO2: 35-45 mmHg
HCO3-: 22-26 mEq/L

197
Q

EXAMPLE #1:

pH: 7.30
pCO2: 50 mmHg
HCO3-: 25 mEq/

A

Respiratory Acidosis, Uncompensated

198
Q

EXAMPLE #2:
pH: 7.40
pCO2: 30 mmHg
HCO3-: 10 mEq/L

A

Metabolic Acidosis, Compensated

199
Q

EXAMPLE #2:
pH: 7.40
pCO2: 30 mmHg
HCO3-: 10 mEq/L

A

Metabolic Acidosis, Compensated

200
Q

EXAMPLE #3:

pH: 7.10
pCO2: 40 mmHg
HCO3-: 18 mEq/L

A

Metabolic Acidosis, Uncompensated

201
Q

EXAMPLE #4:

pH: 7.22
pCO2: 50 mmHg
HCO3-: 32 mEq/L

A

Respiratory Acidosis, Partially Compensated

202
Q

EXAMPLE #5;

pH: 7.52
pCO2: 28 mmHg
HCO3-: 45 mEq/L

A

Mixed alkalosis

203
Q

● aka “Oxygen Dissociation Curve”

A

OXYHEMOGLOBIN DISSOCIATION CURVE

204
Q

OXYHEMOGLOBIN DISSOCIATION CURVE is aka

A

“Oxygen Dissociation Curve”

205
Q

It is a graphical representation of hemoglobin
affinity to oxygen

A

. OXYHEMOGLOBIN DISSOCIATION CURVE

206
Q

Hemoglobin transports oxygen to areas (left
and right) with low oxygen tension

A

OXYHEMOGLOBIN DISSOCIATION CURVE

207
Q

Hemoglobin transports ___ to areas (left
and right) with _____

A

oxygen;
low oxygen tension

208
Q

SHIFT TO THE LEFT

A

● ↑ O2 affinity
● ↑ pH (Alk)
● ↓ pCO2
● ↓ 2,3-BPG/DPG
● ↓ Temperature

209
Q

SHIFT TO THE RIGHT

A

● ↓ O2 affinity
● ↓ pH (Acid)
● ↑ pCO2
● ↑ 2,3-BPG
● ↑ Temperature

210
Q

2,3-BPG meaning

A

2,3-Bisphosphoglycerate

211
Q

2,3-BPG/DPG Purpose

A

When bound to hemoglobin, it
decreases its affinity

212
Q

↑BPG/DPG = _____ O2 affinity

A

↓ (vice versa)

213
Q

OXYGENATION:

Normal pO2: ___

A

80-100 mmHg

214
Q

OXYGENATION:

Hypoxemia: ____ pO2

A

↓pO2

215
Q

Mild Hypoxemia

A

61-80 mmHg

216
Q

Moderate Hypoxemia

A

41-60 mmHg

217
Q

Severe Hypoxemia

A

≤40 mmHg

218
Q

OXYGENATION:

Hypoxemia is seen in:

A

→ Myocardial infarction
→ intestinal pneumonia
→ severe CHF
→ normal individuals living at higher altitudes

219
Q

Specimen used in blood gas analysis

A

Arterial Blood (through arterial puncture)

220
Q

Anticoagulant used in blood gas analysis

A

0.05 mL heparin/mL of blood

221
Q

T/F: the 0.05 mL heparin/mL of blood, is the green top tube

A

F; NOT THE GREEN TOP TUBE

222
Q

BLOOD GAS ANALYSIS:

Syringe to be used for collection should be
____ by ___ heparin into the
___ of the syringe.

A

preheparinized;
flushing;
interior

223
Q

BLOOD GAS ANALYSIS:

T/F: Blood should not be exposed in air during the collection only.

A

F; Blood should not be exposed in air DURING AND AFTER the collection

224
Q

In blood gas analysis, the presence of air/air bubbles in the specimen will:

A

↑pO2 for 4mmHg/2 mins
↓pCO2 for 4mmHg/2 mins = false inc. in pH

225
Q

T/F: In blood Gas Analysis, Blood samples should be chilled during
transport

A

T

226
Q

Ways to chill the blood sample

A

ice/ice bath/ice slurry

227
Q

Why Blood samples should be chilled during
transport?

A

Because ice will prevent:
✓ oxygen consumption by RBC
✓ glycolysis

228
Q

Ice prevents what

A

✓ oxygen consumption by RBC
✓ glycolysis

229
Q

Blood Gas Analysis:

Specimen Consideration:

On standing, pH and pO2 = ____; while pCO2 is ___

A

→ pH and pO2: increased
→ pCO2: decreased

230
Q

According to _____ the specimen (____)
must be processed within ____ and should be
stored at ____

A

Clinical and Laboratory Standards
Institute (CLSI);
arterial blood;
30 mins;
room temperature

231
Q

Glycolysis results to ___ (inc/dec) blood pH

A

decrease

232
Q

results to decrease blood pH

A

Glycolysis

233
Q

most common pre-analytic error

A

Excess heparin causes downward shifting of
blood pH

234
Q

Excess heparin causes downward shifting of
blood pH causes false ___ (inc/dec) in pH

A

false ↓ in pH (acidity)

235
Q

t/f: lower temperatures cause ___ oxygen
solubility in blood and a ____ shift in the
oxyhemoglobin curve resulting in ____
combining with ____

A

increased;
left shift;
more oxygen;
hemoglobin

236
Q

What are the 4 Pre-Analytical Variables under laboratory analysis (blood gas analysis)

A

Temperature
Elevated Plasma Proteins
Bacterial Contamination
Improper Transport

237
Q

most important factor (pre-analytical variable)

A

Temperature

238
Q

LABORATORY ANALYSIS: (blood gas analysis)

Normal temp

A

37°C ± 0.1°C

239
Q

T/F Analyzers used should be maintained at a
constant temperature (38°C ± 0.1°C)

A

F; 37°C ± 0.1°C

240
Q

Why constant temp is important in analyzers

A

bec for every
1°C above 37°C = ↓7% pO2 : ↑3% pCO2 : ↓pH 0.015

241
Q

Protein buildup in the analyzer will affect pO2

A

Elevated Plasma Proteins

242
Q

Bacterial Contamination Will cause false ___ in ___because the ___
are consumed by ___

A

↓
pO2
oxygen
bacteria

243
Q

Same with temperature

A

Improper Transport

244
Q

What are the two laboratory methods under blood gas analysis

A

Gasometer
Electrodes

245
Q

methods under gasometer

A
  1. Van Slyke
  2. Natelson
246
Q

Natelson - uses reagents:

A

→ Mercury
→ Caprylic alcohol
→ Lactic acid
→ Sodium hydroxide (NaOH) & Sodium
hydrosulfate (NaHSO3)

247
Q

create vacuum

A

Mercury

248
Q

antifoam reagent; prevent
the formation of air bubbles

A

Caprylic alcohol

249
Q

What are the 3 electrodes

A

pH
pO2
pCO2

250
Q

pH method

A

potentiometry

251
Q

electrodes in pH

A

Ag-AgCl
Calomel (Hg2Cl2)
Gas electrode

252
Q

reference method/electrode for pH

A

Ag-AgCl

253
Q

most common electrode used
for pH

A

Gas electrode

254
Q

pO2 electrode

A

Clark electrode

255
Q

pO2 method

A

polarography-amperometry

256
Q

pCO2 electrode

A

Severinghaus electrode

257
Q

pCO2 method

A

potentiometry

258
Q

T/F: In modern analyzers pH, PO2, PCO2 cannot be
measured at the same time

A

F; In modern analyzers, these 3 electrodes are
already present; therefore they can all be
measured at the same time

CC II (lec) (4 decks)

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