metabolism - abg

Question 1

what is the definition of a buffer base

Answer 1

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

Question 2

what are the possible metabolic indicies

Answer 2

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

Question 3

how is plasma bicarbonate measured

Answer 3

its calculated via henderson hasselbach equation

Question 4

what is plasma bicarbonate often called

Answer 4

hco2

Question 5

what is plasma hco3 affected by the most

Answer 5

metabolice statue

Question 6

what is plasma hco3 affected by the least

Answer 6

respiratory system

Question 7

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

Answer 7

hco3 will increase and it will be fasley high

Question 8

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

Answer 8

increases by 1

Question 9

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

Answer 9

it decreases by 1

Question 10

when measuring standard bicarbonate what will happen to the hco3 value

Answer 10

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

Question 11

what is the most accurate hco3 metabolic index

Answer 11

t40 standard bicarbonate

Question 12

what happens to the buffer base during respiratory acidosis

Answer 12

it should remain normal

Question 13

what are normal buffer base levels

Answer 13

48-52 mE/L

Question 14

during hypercapnia buffer base will be falsely what

Answer 14

low

Question 15

does buffer base depend on hemoglobin concentration

Answer 15

yes

Question 16

what is normal base excess numbers

Answer 16

-2 to +2

Question 17

what happens to base excess during hypercarbea

Answer 17

gives falsely low readings difference b/w norma

Question 18

what is the base excess of ecf

Answer 18

reflects all extracellular fluid, including plasma and interstitial fluid

Question 19

what does the base excess of elf correct for

Answer 19

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

Question 20

what is tco2

Answer 20

total co2 in blood plasma

Question 21

what is the total co2 formal

Answer 21

tco2= (40 x .03) + 24

normal is 25.2

Question 22

why is tco2 helpful

Answer 22

it is helpful to compare it with hco3 for accuracy

Question 23

what are the 2 most accurate metabolic indices

Answer 23

base excess of elf and t40 standard

Question 24

why will base excess by falsely low

Answer 24

due to invivo / invitro

Question 25

what is most predictable for metabolic acid in terms of compensation

Answer 25

hyperventilation and respiratory compensation

Question 26

what is least predictable for metabolic all in terms of compensation

Answer 26

respiratory compensation and hypoventilation

Question 27

what does the ph always represent

Answer 27

the primary insult

Question 28

what is the best base excess metabolic indice

Answer 28

be ecf

Question 29

what is the best hco3 metabolic indice

Answer 29

t40 standard

Question 30

what will cause the primary event in a metabolic problem

Answer 30

hco3 issue

Question 31

what compensates for a primary problem for a metabolic issue

Answer 31

paco2

Question 32

what will cause the primary problem in respiratory issue

Answer 32

paco2

Question 33

what compensates for a respiratory problem

Answer 33

hco3

Question 34

what does the law of electroneutrality state

Answer 34

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

Question 35

what is an example of an electroneutral substance

Answer 35

plasma

Question 36

what 3 abnormalities produce acid

Answer 36

``` lungs = increased volatile acid kidneys = increased fixed acid or decrease in bases ```

Question 37

what does the anion gap differentiate

Answer 37

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

Question 38

what is the normal anion gap

Answer 38

12 meq/l

Question 39

what is the anion gap formula

Answer 39

``` ag = Na - (Cl + HCO3) 12= 142 - (103 +27) ```

Question 40

what happens when you buffer fixed acids

Answer 40

you use up hco3 during buffering and make more unmeasured anions

Question 41

when ph goes to acid what do you see

Answer 41

increase in fixed acids increased in volatile acids decrease in base

Question 42

when ph goes to alk what do you see

Answer 42

decrease in volatile decrease in fixed increase in bases

Question 43

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

Answer 43

increase in cl- so the anion doesn't change

Question 44

when is the ONLY time you do an anion gap

Answer 44

metabolic acidemia

Question 45

what happens during sepsis

Answer 45

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

Question 46

what is the only exception to the amino gap rule

Answer 46

hcl

Question 47

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

Answer 47

there is no way other than history