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236 spring 14 > metabolism - abg > Flashcards

metabolism - abg Flashcards

1
Q

what is the definition of a buffer base

A

the sum of all anions in one liter of blood available to buffer

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2
Q

what are the possible metabolic indicies

A 
plasma bicarb
standard bicarb
t40 standard bicarb
buffer base
base excess
total co2
ph-paco2 relationship
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3
Q

how is plasma bicarbonate measured

A

its calculated via henderson hasselbach equation

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4
Q

what is plasma bicarbonate often called

A

hco2

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5
Q

what is plasma hco3 affected by the most

A

metabolice statue

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6
Q

what is plasma hco3 affected by the least

A

respiratory system

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7
Q

what happens to hco3 when paco2 is increased due to the law of mass action

A

hco3 will increase and it will be fasley high

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8
Q

for every 10 mmhg of paco2 increase how much does hco3 go up by

A

increases by 1

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9
Q

for every 5 mmhg decrease of paco2 how far down does hco3 go by

A

it decreases by 1

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10
Q

when measuring standard bicarbonate what will happen to the hco3 value

A

it will be falsely low do to vivo-in vitro discrepancies

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11
Q

what is the most accurate hco3 metabolic index

A

t40 standard bicarbonate

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12
Q

what happens to the buffer base during respiratory acidosis

A

it should remain normal

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13
Q

what are normal buffer base levels

A

48-52 mE/L

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14
Q

during hypercapnia buffer base will be falsely what

A

low

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15
Q

does buffer base depend on hemoglobin concentration

A

yes

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16
Q

what is normal base excess numbers

A

-2 to +2

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17
Q

what happens to base excess during hypercarbea

A

gives falsely low readings difference b/w norma

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18
Q

what is the base excess of ecf

A

reflects all extracellular fluid, including plasma and interstitial fluid

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19
Q

what does the base excess of elf correct for

A

shifts of bases that occur under in-vivo conditions b/w the plasma and the interstitial fluid

20
Q

what is tco2

A

total co2 in blood plasma

21
Q

what is the total co2 formal

A

tco2= (40 x .03) + 24

normal is 25.2

22
Q

why is tco2 helpful

A

it is helpful to compare it with hco3 for accuracy

23
Q

what are the 2 most accurate metabolic indices

A

base excess of elf and t40 standard

24
Q

why will base excess by falsely low

A

due to invivo / invitro

25
Q

what is most predictable for metabolic acid in terms of compensation

A

hyperventilation and respiratory compensation

26
Q

what is least predictable for metabolic all in terms of compensation

A

respiratory compensation and hypoventilation

27
Q

what does the ph always represent

A

the primary insult

28
Q

what is the best base excess metabolic indice

A

be ecf

29
Q

what is the best hco3 metabolic indice

A

t40 standard

30
Q

what will cause the primary event in a metabolic problem

A

hco3 issue

31
Q

what compensates for a primary problem for a metabolic issue

A

paco2

32
Q

what will cause the primary problem in respiratory issue

A

paco2

33
Q

what compensates for a respiratory problem

A

hco3

34
Q

what does the law of electroneutrality state

A

if body becomes depleted in one anion it increase in another anion to keep charges equal

35
Q

what is an example of an electroneutral substance

A

plasma

36
Q

what 3 abnormalities produce acid

A 
lungs = increased volatile acid
kidneys = increased fixed acid or decrease in bases
37
Q

what does the anion gap differentiate

A

b/w an increase in fixed acids or a decrease in bases

38
Q

what is the normal anion gap

A

12 meq/l

39
Q

what is the anion gap formula

A 
ag = Na - (Cl + HCO3)
12= 142 - (103 +27)
40
Q

what happens when you buffer fixed acids

A

you use up hco3 during buffering and make more unmeasured anions

41
Q

when ph goes to acid what do you see

A

increase in fixed acids
increased in volatile acids
decrease in base

42
Q

when ph goes to alk what do you see

A

decrease in volatile
decrease in fixed
increase in bases

43
Q

what happens to the anion gap if the primary problem is the base

A

increase in cl- so the anion doesn’t change

44
Q

when is the ONLY time you do an anion gap

A

metabolic acidemia

45
Q

what happens during sepsis

A

large amounts of NaCl are given which may increase the level of chloride and decrease the anion gap

46
Q

what is the only exception to the amino gap rule

A

hcl

47
Q

if you have metabolic alkalemia how can you tell them apart (whether it is caused by decrease in fixed acids or increase in bases

A

there is no way other than history

236 spring 14 (13 decks)

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