Oxygen content/Hemoglobin Problems

Question 1

Sigmoidal shape is due to?

Answer 1

Positive cooperativity

Question 2

Myoglobin lacks positive cooperativity because it is?

Answer 2

Monomeric

Question 3

What Right Shifts the curve?

Answer 3

Right shift—ACE BATs right handed: 
Acid (1. Due to severe anemia=>lactic acidosis or 2. Hypoventilation=>Resp. Acidosis)
CO2/Cl
Exercise (strenous exercise)
2,3-BPG 
Altitude 
Temperature

Question 4

Normal Hemoglobin content is about?

Answer 4

15 g/dL

Question 5

O2 content=?

Answer 5

(O2 binding capacity (Hb)*% saturation)+Dissolved O2 (PaO2)

Question 6

In both methemoglobin and Carboxyhemoglobin, you get decreased O2 content because?

Answer 6

of decreased O2 saturation

Question 7

Methemoglobin has affinity for O2 or CN?

Answer 7

CN

Question 8

Methemoglobinemia what two things will you see in the patient?

Answer 8

Cyanosis and Chocolate-colored blood**

Question 9

Tx of Methemoglobinemia?

Answer 9

Methylene blue

Question 10

Induce Methemoglobinemia with?

Answer 10

nitrite and sulfa drugs

Question 11

Where can you also see alot of nitrite?

Answer 11

Mountain Streams

Question 12

Why is Carboxyhemoglobin dangerous?

Answer 12

B/c it left shifts the curve

Question 13

How do you treat Carboxyhemoglobin?

Answer 13

100% O2

Question 14

Typical CO poisoning question stem?

Answer 14

Smoke from Fires

Exhaust cars

Question 15

Earliest sign of CO poisoning?

Answer 15

Headache

Question 16

What other symptom do you see in a patient with CO poisoning?

Answer 16

Cherry Red Appearance

Question 17

In anemia and polycythemia, what changes Hb? % sat? Dissolved O2 (PaO2)

Answer 17

Hb Conc.

Question 18

In CO poisoning what changes?

Answer 18

% Sat

Question 19

What changes in High Altitude?

Answer 19

decreased (PaO2)

Question 20

In high altitude what kind of metabolic change do you get?

Answer 20

Respiratory alkalosis

Question 21

Respiratory alkalosis is due to?

Answer 21

Peripheral Chemoreceptors telling the body to Hyperventilate

Question 22

What are other changes with high altitude?

Answer 22

Findings ways to increase O2 content

1. Hyperventilation
2. Increased production of EPO
3. Increased 2,3 BPG bindings
4. Increased mitochondria (ATP)
5. Increased excretion of HCO3- to compensate for Resp. Alkalosis
6. Hypoxic vasoconstriction

Question 23

With Hypoxic vasoconstriction, what can it lead to?

Answer 23

RVH

Question 24

How do you treat resp. alkalosis in high altitude states?

Answer 24

Acetazolamide

Question 25

In response to exercise, there are two things that do not change or get more uniform. What are they?

Answer 25

1. No change in PaO2 and PaCO2 | 2. V/Q ratio becomes more uniform

Question 26

During Strenous Exercise, what happens to pH? Due to?

Answer 26

pH decreases due to lactic acidosis

Question 27

By V/Q ratio becoming more uniform, what happens to the dead space?

Answer 27

Decreases

Question 28

No change in PaO2 and PaCO2 means that the rate of blood flow must be?

Answer 28

Equal

Question 29

Most of CO2 is carried in which form?

Answer 29

HCO3

Question 30

Which hemoglobin form does CO2 like?

Answer 30

Taut

Question 31

In the lungs O2 curve is shifted to the left because?

Answer 31

Hb dissociates with H+

Question 32

In the Tissues O2 curve is shifted to the Right because?

Answer 32

Increased H+ from Tissue=>shifts curve to right=>unloads tissue