Oxygen Physiology

Question 1

During Oxidative Phosphorylation ______ gross ATP ______ are produced and_______ net________ are produced along with__________co2 molecules.

Answer 1

38 gross ATP are produced and 36 ATP are Net long with 6 Co2 molecules.

Question 2

Etco2 is ________ than PaCo2

Answer 2

less than by 3-5 points

Question 3

What is SaO2?
What is SVo2 and where can you get a sample?

Answer 3

Amount of hemoglobin in the blood.
Svo2 is a mix venus O2 saturation can get a sample from a distal port on the swan ganz cath.

Question 4

Scvo2 ? Sample?

Answer 4

Central venous O2 sat can get a sample from the distal port of the central line.

Question 5

What is Do2

Answer 5

delivery of oxygen each minute

Question 6

Deficiency in alveolar air exchange?
Reduction is O2 carrying capacity in the blood anemia bleeding and certain drugs?
Reduced Q, heart failure, PE, Shock
Poisoning or metabolic disorders such as cyanide or, ETOH or Carbon dioxide poisoning

Answer 6

Hypoxic hypoxia

Hypemic Hypoxia

Stagnant hypoxia

histotoxic hypoxia

Question 7

_________________________ is a shift in the oxygen dissociation curve caused by a change in the concentration of carbon dioxide
( PH)

Answer 7

Bohr effect

Question 8

What is the biggest aspect of O2 delivery?

Answer 8

Hemoglobin concentration

Question 9

The Fick Principle simply states that at rest, the oxygen going into an organ minus the oxygen left out of an organ must equal how much oxygen that organ has used. Using the Fick Principle’s equation of (cardiac output = oxygen consumption/arteriovenous oxygen difference), cardiac output can be calculated.

Question 10

What is H2Co3
How does carbonic break down in the lungs?
How does carbonic acid break down in the muscles?

Answer 10

Carbonic acid
H+HCo3 blown off by the lungs

C02 + H2o. H20 is absorbed by the skin and

Question 11

For every change in the PaCo2 by 10 the _________ will change _______ in the opposite direction.

Answer 11

Ph will change by 0.08 in the opposite direction

Question 12

For every _______Meq /L of HCO3, the PH will change by ________ in the same direction.

Answer 12

10 MeQ the HCO3 will change by .15 in the same direction

Question 13

For every change in PH of _________the K+ will change by __________ In the opposite direction

Answer 13

0.10 the k+ will change by 0.6 in the opposite direction.

Question 14

Ph 7.40
Co2 40
K 5.4

The Co2 increases to 50 what is your PH?

Question 15

What electrolytes are used to calculate the Anion gap?

Answer 15

Sodium Na+
Chloride Cl
HCO3 bicarb
K+ Potassium

Question 16

What are the 2 equations for the Anion gap

Answer 16

Na+ - ( Cl + HCO3) + K = Anion Gap
Na+ - (Cl+HC03) = anion gap

Question 17

What is the reference range for the anion gap if the equation with potassium is used?

Answer 17

10-20 mmol/L

Question 18

What is the reference range for the anion gap if the equation without potassium is used?

Answer 18

8-16 mmol/L

Question 19

What are the causes of an increased anion gap due to a metabolic acidosis?

Answer 19

Gold Mark
Glycols (ethylene glycol & propylene glycol)

Oxoproline (metabolite of acetaminophen)

L-lactate

D-lactate (acetaminophen, short bowel syndrome, propylene glycol infusions for lorazepam and phenobarbital)

Methanol

ASA

Renal Failure

Ketoacidosis (starvation, alcohol and DKA)

Question 20

A 55-year-old gentleman is 1 week post right hemicolectomy for colorectal cancer. He complains of intermittent shortness of breath and his arterial blood gas shows the following;

Normal range
pH: 7.25 (7.35 - 7.45)
pO2: 11.1 (10 - 14)kPa
pCO2: 3.2 (4.5 - 6.0)kPa
HCO3: 11 (22 - 26)mmol/l
BE: -15 (-2 to +2)mmol/l

Na+ 110mmol/l
K+ 3mmol/l
Chloride 100mEq/L

Based on this information provided, what is the anion gap?

Answer 20

2

Question 21

The patient has the following ABG values and vital signs: pH 7.10, PaCO2 54mmHg, HCO3 24, PaO2 92, EtCO2 50 mmHg, SpO2 92%. Upon arrival at the receiving facility, your EtCO2 is reflecting 30 mmHg, what would your change in pH reflect?

Answer 21

7.26 it moved 20 so it jumped 2 times making it .16 + the PH 7.10= 7.26

Question 22

pH 7.60, PaCO2 35, HCO3 42, PaO2 82, BE 10
pH 7.41, PaCO2 34, HCO3 24, PaO2 82, BE
pH 7.58, PaCO2 46, HCO3 35, PaO2 46, BE 8
pH 7.08, PaCO2 114, HCO3 18, PaO2 56, BE -8
pH 6.83, PaCO2 15, HCO3 6, PaO2 110, BE -20
pH 7.55, PaCO2 35, HCO3 30, PaO2 49, BE 9

Answer 22

Uncompensated Metabolic Alkalosis
Compensated Respiratory Alkalosis
Partially Compensated Metabolic Alkalosis
Mixed Disturbance

Partially Compensated Metabolic Acidosis
Uncompensated Metabolic Alkalosis w/ hypoxemia

Question 23

A condition where the body produces excess antidiuretic hormone leading to water retention and low sodium levels in the bod

Answer 23

SIADH Syndrome of inappropriate antidiuretic hormone secretion Holds on to urine and dilutes the sodium so it is low.

Question 24

Abnormal twitching of muscles innervated by the facial nerve when tapped in front of the ear.

involuntary contraction of the muscles in the hand and wrist (i.e., carpopedal spasm) that occurs after the compression of the upper arm with a blood pressure

These symptoms may indicate

Answer 24

Chvosteks Sign

Trousseau’s sign refers to the involuntary contraction of the muscles in the hand and wrist (i.e., carpopedal spasm) that occurs after the compression of the upper arm with a blood pressure

Hypocalcemia

Question 25

A great way to remember the components of white blood cells

Answer 25

NEVER – Neutrophils
LET – Lymphocytes
MONKEYS – Monocytes
EAT– Eosinophils
BANANAS – Basophils

Question 26

serum Osmolality normal range
What is serum Osmolality?
A high Osmolality indicates?
Name an example of high Osmolality and Low Osmolality.

Answer 26

275-295
amount of solute in a part of blood.
A highly concentrated state like diabetes insipidus ( releases too much water. A low Osmolality holds onto water and floods the cell saturating the concentration.

Question 27

Urine Specific gravity normal range? What is urine-specific gravity?

Answer 27

1.005-0.130
the ratio of urine and water
a low specificity indicates an over-dilution of solutes like diabetes insipidus urinating a lot and the dilute is concentrated.
a high specificity indicates an over-dilution of solutes like SIADH. Know this for the test.

Question 28

Troponin l normal range
Troponin l is detected after how long after the injury? and peek at?

Answer 28

< 0.04 ng/ml
2-3 hours Peak 24 hrs.
last 2 weeks.

Question 29

Ck MB normal range?
Where is it found
Abnormal cardiac range?

Answer 29

0-3 ng/ml
cardiac muscle and some muscle.
> 2.5-3.0 is likely cardiac < 2.5 is likely muscle.

Question 30

Pro BNP normal range Ventricuar stretch

Answer 30

< 100 Pg/ml