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Module 2 Flashcards

Basics of Acid-Base Balances; Hematology & Coagulation

1
Q

Normal Values for pH

A

7.35-7.45pH

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2
Q

Normal Values for HCO3 (Bicarb)

A

20-24mEq/L

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3
Q

Normal Values for CO2 (carbon dioxide)

A

35-45mmHg

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4
Q

Normal Values for Sodium (Na+)

A

135-145mEq/L

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5
Q

Normal Values for Potassium (K+)

A

3.5-5mEq/L

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6
Q

Normal Values for Chloride (Cl-)

A

100mEq/L

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7
Q

Assume Bicarb levels are ok. When pH is high and CO2 is low, it is _____________.

A

Respiratory Alkalosis

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8
Q

Assume Bicarb levels are ok. When pH is low and CO2 is high, it is __________.

A

Respiratory Acidosis

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9
Q

Assume CO2 levels are ok. When pH is high and HCO3 is high, it is _____________.

A

Metabolic Alkalosis

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10
Q

Assume CO2 levels are ok. When pH is low and HCO3 is low, it is ____________.

A

Metabolic Acidosis

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11
Q

In relation to respiration, what could the pt be doing that would cause blood pH to raise?

A

Hyperventilation

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12
Q

in relation to respiration, what could the pt be doing that would cause blood pH to lower?

A

Hypoventilation

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13
Q

Hypoxia results from the ______ of _______ to get _______ amounts of _______ from the blood.

A

inability; tissues; adequate; oxygen

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14
Q

Where are clotting factors made?

A

Liver

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15
Q

Which of the following compensatory changes are most likely to occur in someone who has a condition that causes a decrease in RBC production?
A: Hypovolemia
B: Tachypnea
C: Bradycardia
D: Hypotension

A

B

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16
Q

True or False: RBCs each contains a large amount of hemoglobin

A

True

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17
Q

Describe what causes the body to make more RBCs and its process

A

Kidneys sense low O2 –> Kidneys release erythropoietin –> erythropoietin tells bone marrow to make more RBCs (erythrocytes)

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18
Q

What is the purpose of platelets?

A

to help form blood clots

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19
Q

A 75 year old has a blood clot in their left leg. They have noticed that their left leg has looked more swollen lately. What is the reason?

A

Decreased re-absorption due to decrease capillary oncotic pressure

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20
Q

What is the function of hemoglobin?

A

To transport oxygen from the lungs to the tissue & carbon dioxide from the tissues to the lungs

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21
Q

What is the function of a RBC?

A

to carry oxygen from the lungs to the tissues

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22
Q

What is the function of a WBC?

A

to respond and fighting infections in the body

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23
Q

What is the function of lymphocytes? What type of cells do they consist of?

A

consists of T cells, NK cells, and B cells to protect against viral infections and produce proteins to help you fight infection (antibodies)

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24
Q

What is the function of neutrophils? What type of cells do they consist of?

A

they’re most abundant; help protect the body from infections by bacteria, fungi, and foreign debris by phagocytosis

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25
Q

What is the function of Eosinophils?

A

identify and destroy parasites, cancer cells, and assist basophils with allergic response

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26
Q

What is the function of basophils?

A

produce an allergic response, such as coughing, sneezing, or a runny nose

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27
Q

What is the function of Monocytes?

A

defend against infection by cleaning up damaged cells through phagocytosis

28
Q

What is another name for Monocytes?

A

Macrophages

29
Q

Intrinsic Pathway or Extrinsic Pathway: Heparin; describe the pathway

A

Intrinsic - heparin thins the blood by blocking part of the clotting cascade which allows the blood to flow past the clot and prevent events from attaching to the existing clot (making it bigger)

30
Q

Intrinsic Pathway or Extrinsic Pathway: Warfarin

31
Q

Explain why a patient with sickle cell would feel better with a nasal cannula when they’re experiencing a sickle cell crisis

A

during a sickle cell crisis, the RBC changes shape, making it harder for the cell to carry oxygen. therefore, the nasal cannula helps the patient get oxygen to the body, making them feel better and relaxed

32
Q

Commons causes of microcytic hypochromic anemia

A
  • chronic blood loss
  • iron deficiency
33
Q

Common causes of macrocytic normochromic anemia

A
  • folic acid deficiency
  • B12 deficiency
34
Q

Common causes of normocytic normochromic anemia

A
  • acute blood loss
  • bone marrow failure
  • chronic disease
  • cancer
35
Q

What neutralizes acid in the body?

A

bicarbonate

36
Q

What is the chemical formula for bicarb?

37
Q

What does excessive acid production do to the blood pH?

A

lower it; becomes more acidotic

38
Q

What does lack of HCO3 production do to the blood pH?

A

lower it; becomes more acidotic

39
Q

What is the normal range of BP?

A

90-120 systolic / 60-80 diastolic

40
Q

When a patient is excessively vomiting, what do we need to worry about?

A

Metabolic Alkalosis

41
Q

When a patient is experiencing excessive diarrhea, what do we need to worry about?

A
  • Dehydration
  • Metabolic acidosis
42
Q

When someone is over-exercising, what kind of ABG are you going to expect?

A
  • low pH
  • normal CO2
  • low bicarb
43
Q

How do you distinguish what type of metabolic acidosis your patient has?

A

Anion gap (normal ~12mmol/L)

44
Q

What does a normal anion gap tell you?

A

the patient is experiencing metabolic acidosis bc of loss of bicarb

45
Q

What does an elevated anion gap tell you?

A

the patient is experiencing metabolic acidosis bc of acid build-up

46
Q

When a patient is experiencing a panic attack, what can you expect from an ABG result?

A
  • high pH
  • low CO2
  • normal bicarb
47
Q

If a patient is experiencing vomiting, what can you expect from an ABG result?

A
  • high pH
  • normal CO2
  • high bicarb (the patient is losing acid through vomiting)
48
Q

What are the symptoms of severe anemia?

A

SOB; tachycardia; tachypnea; dyspnea on exertion; cramping; insomnia

49
Q

What lab values will give you clues as to what type of anemia your patient has?

A
  • RBC count
  • MCH (Mean Corpuscular Hemoglobin): average amount of hemoglobin in each RBC
  • MCV (Mean Corpuscular Volume): average volume (size) of each RBC
50
Q

What is hematocrit?

A

% of erythrocytes in total volume

51
Q

Hemoglobin Structure: how many protein chains are there?

52
Q

Hemoglobin Structure: on each chain, how many heme groups are on there?

53
Q

Hemoglobin Structure: how much oxygen can a heme molecule hold?

54
Q

Hemoglobin Structure: in total each hemoglobin molecule can carry how many oxygen molecules?

55
Q

Why would a person going through a sickle cell crisis experience severe pain?

A

during a crisis, the RBC changes shape from round to crescent shape which can cause them to get stuck and cause occlusions in small blood vessels

56
Q

What other characteristics are associated with higher hemoglobin affinity?

A

increase in pH; colder temperature; lower CO2 –> think you’re resting, you’re colder and your CO2 levels are low bc you’re not exerting any energy to convert O2 into CO2 and your pH increases bc there’s no acid being made (from exercising)

57
Q

What other characteristics are associated with lower hemoglobin affinity?

A

decrease pH; warmer temperature; higher CO2 –> think when you’re exercising, so you get warmer and you’re building lactic acid (therefore decrease pH) and your CO2 levels increase (when there’s more acid, there’s more CO2)

58
Q

Acidotic or Alkalotic: Hypothermia

59
Q

What is tPA?

A

clot buster

60
Q

Explain the common pathway in the clotting cascade

A

Factor X converts to Factor Xa; Prothrombin (II) converts to Thrombin (IIa); Fibrinogen (I) converts to Fibrinogen (Ia) and then to Fibrin Clot

61
Q

What is a D-Dimer?

A

leftover from fibrinolysis

62
Q

What is Protein C & S?

A

natural anticoagulants (inactive clotting factors)

63
Q

What is Anti-Thrombin III?

A

turns of thrombin (natural anticoagulant)

64
Q

Name for clotting factor 8

A

Hemophilia A

65
Q

Name for clotting factor 9

A

Hemophilia B (aka Christmas)

Pathophysiology (4 decks)

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