Oxygen content/Hemoglobin Problems Flashcards
Sigmoidal shape is due to?
Positive cooperativity
Myoglobin lacks positive cooperativity because it is?
Monomeric
What Right Shifts the curve?
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
Normal Hemoglobin content is about?
15 g/dL
O2 content=?
(O2 binding capacity (Hb)*% saturation)+Dissolved O2 (PaO2)
In both methemoglobin and Carboxyhemoglobin, you get decreased O2 content because?
of decreased O2 saturation
Methemoglobin has affinity for O2 or CN?
CN
Methemoglobinemia what two things will you see in the patient?
Cyanosis and Chocolate-colored blood**
Tx of Methemoglobinemia?
Methylene blue
Induce Methemoglobinemia with?
nitrite and sulfa drugs
Where can you also see alot of nitrite?
Mountain Streams
Why is Carboxyhemoglobin dangerous?
B/c it left shifts the curve
How do you treat Carboxyhemoglobin?
100% O2
Typical CO poisoning question stem?
Smoke from Fires
Exhaust cars
Earliest sign of CO poisoning?
Headache
What other symptom do you see in a patient with CO poisoning?
Cherry Red Appearance
In anemia and polycythemia, what changes Hb? % sat? Dissolved O2 (PaO2)
Hb Conc.
In CO poisoning what changes?
% Sat
What changes in High Altitude?
decreased (PaO2)
In high altitude what kind of metabolic change do you get?
Respiratory alkalosis
Respiratory alkalosis is due to?
Peripheral Chemoreceptors telling the body to Hyperventilate
What are other changes with high altitude?
Findings ways to increase O2 content
- Hyperventilation
- Increased production of EPO
- Increased 2,3 BPG bindings
- Increased mitochondria (ATP)
- Increased excretion of HCO3- to compensate for Resp. Alkalosis
- Hypoxic vasoconstriction
With Hypoxic vasoconstriction, what can it lead to?
RVH
How do you treat resp. alkalosis in high altitude states?
Acetazolamide
In response to exercise, there are two things that do not change or get more uniform. What are they?
- No change in PaO2 and PaCO2
2. V/Q ratio becomes more uniform
During Strenous Exercise, what happens to pH? Due to?
pH decreases due to lactic acidosis
By V/Q ratio becoming more uniform, what happens to the dead space?
Decreases
No change in PaO2 and PaCO2 means that the rate of blood flow must be?
Equal
Most of CO2 is carried in which form?
HCO3
Which hemoglobin form does CO2 like?
Taut
In the lungs O2 curve is shifted to the left because?
Hb dissociates with H+
In the Tissues O2 curve is shifted to the Right because?
Increased H+ from Tissue=>shifts curve to right=>unloads tissue
