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RT-104B > Midterm 2 > Flashcards

Midterm 2 Flashcards

1
Q

A pt. w/ Kussmaul’s respirations most likely has?

A

Metabolic Acidosis

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2
Q

Which organ system maintains the normal lvl of HCO3- at 24mEq/L?

A

Renal System

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3
Q

An ABG result shows the pH to be 7.56 and the HCO3- to be 23 mEq/L. Which of the following is the most likely disorder?

A

Respiratory Alkalosis

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4
Q

When is the rate of gaseous diffusion across a biological membrane decreased?

A

The partial pressure gradient is low

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5
Q

What is the average thickness of the Type I alveolar cell?

A

0.1-0.5 microns

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6
Q

Based on the following ABG results, what is the most likely acid-base diagnosis?
pH 7.38, PCO2 21mmHg, HCO3- 11.7 mEq/L

A

Fully compensated metabolic acidosis

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7
Q

The affinity of Hb for carbon monxide (CO) is approximately how many times greater than its affinity for oxygen?

A

200 or greater

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8
Q

In order to assess the events occurring at the tissue level, especially tissue oxygenation, what parameter would you sample and measure?

A

Mixed venous blood

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9
Q

According to the Bohr effect, when the pH drops, what happens?

  1. The affinity of Hb for oxygen decreases
  2. The Hb saturation for a given PO2 falls
  3. The Hb saturation fo a given PO2 rises
A

1 &2

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10
Q

What is the term for the uppermost portion of the uprght lung?

A

Apex

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11
Q

What type of epithelium extends from the trachea to the respiratory bronchioles

A

pseudostratified ciliates columnar

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12
Q

According to the Henderson-Hasselbalch equation, the pH will be normal as long as the ratio of HCO3- to dissolved CO2 is which of the following?

A

20:1

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13
Q

In which of the condition will erythrocyte concentration of 2,-DPG be decreased

A

Banked blood

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14
Q

Causes of respiratory acidosis in pts with normal lungs include which of the following?

  1. neuromuscular disorders
  2. Spinal cord trauma
  3. Anesthesia
  4. Central nervous system
A

1,2,3 and 4

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15
Q

When does a state of alkalemia exist?

  1. The HCO3-/CO2 ratio exceeds 20:1
  2. The blood pH exceeds 7.45
  3. The blood PCO2 exceeds 54 mmHg
A

1 and 2

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16
Q

An area of the lungs has no ventilation but is normally perfused by the pulmonary circulation. Which of the following statements are correct?

  1. Blood exiting the pulmonary capillary will have a PO2 = 40 and a PCO2 = 46
  2. The area represents an alveolar shunt.
  3. The V/Q is 0
A

1,2, and 3

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17
Q

An ABG result shows pH of 7.35 of 30mmHg, and HCO3- of 18 mEq/L. What compensatory measure has the body taken to at least partially compensate for the acid-base disorder?

A

Blown off CO2

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18
Q

Compensation for respiratory alkalosis occurs through what?

A

Renal excretion of HCO3-

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19
Q

Carbon dioxide diffuses across the alveolar-capillary membrane about how many times faster than oxygen?

A

20

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20
Q

An increase in the H+ ion concenration of the [H+] of the blood due only to an increase in the arterial PCO2 (hypercapnia) best describes which?

A

Respiratory acidosis

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21
Q

As the amount of oxygen that dissolves in the plasma increases, what is it directly proportional to?

A

Its partial pressure

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22
Q

What is the primary chemical event in metabolic alkalosis?

A

Increase in blood HCO3- levels

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23
Q

What is the most common cause of respiratory alkalosis?

A

Hypoxemia

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24
Q

Primary metabolic alkalosis is associated with which of the following?

A

Gain of buffer base

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25
Q

What are the primary components of the upper airway?

A

Nose, oral cavity, and pharynx

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26
Q

What compensates for a metabolic alkalosis?

A

Hypoventilation

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27
Q

A decrease in the H+ ion concentration [H+] of the blood caused by a low PaCO2 best describes which of the following?

A

Respiratory alkalosis

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28
Q

What is the approximate normal level of CO2 production for an adult?

A

200ml/min

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29
Q

What affect does hyperventilation have on HCO3- recover in the kidneys?

A

Less H+ excretion, greater HCO3- loss

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30
Q

An area of the lung has no blood flow but is normally ventilated. Which of the following statements are true about this area?

  1. The alveolar gas is like air (PO2 = 150; PCO2 = 0)
  2. The area represents alveolar dead space
  3. The V/Q is elevated
A

1, 2, and 3

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31
Q

The lowest PO2 would normally be found in what location?

A

Cells

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32
Q

What is a normal response of the body to a failure in one component of the acid-base regulatory mechanism?

A

Compensation

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33
Q

What is the primary chemical event in respiratory acidosis?

A

Increase in blood CO2 levels

34
Q

What is the most important component in the oxygen transport system?

35
Q 
Which airways compose the noncartilaginous airways?
I. Subsegmental bronchi
II. Bronchioles
III. Terminal bronchioles
IV. Respiratory bronchioles
A

II, III, and IV

36
Q

At what lvl in the tracheobronchial tree are cilia completely absent?

A

Respiratory bronchioles

37
Q

Which of the following are potential causes of respiator alkalosis?

  1. Anxiety
  2. Central nervous system depression
  3. Hypoxemia
  4. Pain
A

1, 3, and 4

38
Q

In cm, what is the average diameter of the adult trachea?

A

2.0-2.5 cm

39
Q

In acute respiratory acidosis, hat wouldyou expect the BE range to be?

A

+2 to -2 mEq/L (Normal range)

40
Q

How does the total cross-sectional area of the tracheobronchial tree change from the trachea to the respiratory zone?

A

It increases steadily to the terminal bronchioles then increases significantly in the respiratory zone

41
Q

The highest PCO2 levels are found in what location?

42
Q

On what does the movement of gases between the lungs and the body tissues mainly depend?

A

Gaseous diffusion

43
Q

A pt has a bicarbonate concentration of 36 mEq and PCO2 of 60mmHg. What is the approximate pH?

44
Q

Which of the following accurately describes compensation for acid-base disorders?

A

Kidneys take hours to days to compensate for respiratory disorders

45
Q

Which alveolar cells are considered to be te source of pulmonary surfactant?

46
Q

Under normal physiologic circumstances, how many milliliters of oxygen are capable of combining wth 1g of Hb?

47
Q

What type of epithelium is present in the pulmonary capillaries?

A

Simple Squamous cells

48
Q

How many second generation bronchi would you find in a healthy adult tracheobronchial tree?

49
Q

When using therapeutic agents that can cause methemoglobinemia, what is important to prevent adverse effects?

A

Frequent monitoring for methHb to weight the rsk against the benefit

50
Q 
In the face of uncompensated respiratory acidosis, which of the following blood gas abnormalities would you expect to encounter?
1. Decreased pH
2. Increased HCO3-
3. Increased PCO2
4 Increased pH
51
Q

A pt has a pH of 7.49. What would this define?

52
Q

The PAO2 depends on which of the following factors?
1. Ambient (atmospheric) pressure
2. Fractional concentration of inspired O2
3. Level of VA
Types of fuels burned (fat, protein, carbohydrate)

A

1,2,3 and 4

53
Q

Which of the following would you expect to occur if ventilation to an area o the lung remained constant but perfusion to this same area decreased?

  1. The PACO2 should fall
  2. The PAO2 should fall
  3. The V/Q ratio should rise
54
Q

Hypoxia is best defined as a condition in which what occurs?

A

Tissue oxygen delivery is inadequate to meet cellular needs

55
Q

A pts has aP50 of 30mmHg. What does this indicate?

A

Decreased affinity of Hb for oxygen

56
Q

What happens when hte temp. of the blood rises?

  1. The Hb sat. for a given PO2 falls
  2. The HbO2 curve shifts to the right
  3. The affinity of Hb for oxygen increases
57
Q

In the presence of an acutely reduced arterial oxygen content (hypoxemia), normal oxygen delivery to the tissues can be maintained by which of the following?

A

Increasing the cardiac output

58
Q

What does NOT increase the affinity of Hb for oxygen?

A

Increased temp.

59
Q

Metabolic acidosis may be caused by:

  1. An increase in fixed (nonvolatile) acids
  2. An increase in blood carbon dioxide (CO2)
  3. Excessive loss of bicarbonate (HCO3)
60
Q

How is the vast majority of oxygen carried in the blood?

A

Chemically combined with Hb

61
Q

What must exist for gas to move between the alveolus and pulmonary capillary?

A

Diference in partial pressures (pressure grdient)

62
Q

What is the effect of an elevated intracellular 2,3-DPG concentration?

A

Increases the availability of oxygen to the tissues

63
Q

Compensation for metabolic acidosis occurs through which of the following?

A

Decrease in blood CO2 levels?

64
Q

What type of epithelium composes 95% of the alveolar surface?

A

Type I (squamous pneumocyte)

65
Q

A normal person breathing 100% oxygen at sea level would have PAO2 of about what level?

66
Q

What is the highest PAO2 one could expect to observe in an individual breathing room air at sea level?

A

110 to 120 mmHg

67
Q

Which of the following clinical findings would you expect in a fully compensated respiratory acidosis?

  1. Elevated HCO3-
  2. pH below 7.35
  3. pH between 7.35 and 7.39
  4. elevated PO2
68
Q

Which organ system actually excretes H+ from the body?

69
Q

With partially compensated respiratory alkalosis, which of the following blood gas abnormalities would you expect to encounter?

  1. Decreased pH
  2. Decreased HCO3-
  3. Decreased PCO2
  4. Increased pH
A

2, 3, and 4

70
Q

What is the main compensatory mechanism for metabolic acidosis?

A

Hyperventilation

71
Q

What is the primary factor that maintains the pressure gradient that drives oxygen from the capillaries into the interstitial spaces and into the cells?

A

Cellular consumption of oxygen

72
Q

How many bronchopulmonary segments are located in the lower lobe of the right lung?

73
Q

What is the normal arterial blood pH range?

74
Q

What condition or treatment could cause iatrogenic respiratory alkalosis?

A

Mechanical hyperventilation

75
Q

What is the normal range for BE?

A

+/- 2mEq/L

76
Q

Respiratory causes of Respiratory Acidosis

A
  • Acute upper airway obstruction
  • Severe diffuse airway obstruction (acute or chronic)
  • Massive pulmonary edema
77
Q

Nonrespiratory causes of Respiratory Acidosis

A
  • Drug overdose
  • Spinal cord trauma
  • Neuromuscular disease
  • Head trauma
  • Thoracic trauma
  • Gross obesity
78
Q

Causes of Respiratory Alkalosis

A

Hypoxemia
Pain
Anxiety
Can be accidentally induced by Pos. Pressure ventilation

79
Q

Causes of Metabolic Acidosis by increase fixed acids

D.R.I.L.L

A

D.R.I.L.L.

Diabetic Ketoacidosis (e.g., diabetes/starvation)

Renal failure (distal tubules/retention of H+)

Ingestion of acids (e.g., methanol)

Lactic acidosis (shock/anaerobic metabolism)

80
Q

Causes of Metabolic Acidosis by loss of base

Road.Hog.Police.Dept (R.H.P.D.)

A

Renal failure (proximal tubules/loss of HCO3)

Hyperalimentation

Pancreatic fistula

Diarrhea

81
Q

Causes of Metabolic Alkalosis
H.N.P.D.S.E.
SPENHD
DEPN

A
  • Hypokalemia or hypochloremia
  • Nasogastric suction (loss of stomach acid)
  • Persistent vomiting (loss of stomach acid)
  • Diuretic therapy
  • Steroid therapy
  • Excessive administration of sodium bicarbonate

RT-104B (9 decks)

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