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CLINICAL CHEM 2 LEC > P3.1-ACID BASE BALANCE INTRO > Flashcards

P3.1-ACID BASE BALANCE INTRO Flashcards

1
Q

When pH is high, the concentration of hydrogen is

A

low and vice versa

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2
Q

When blood pH is less than the reference range (< 7.35)
o Less than the minimum limit of normal
 Reflects excess acid or hydrogen ion concentration
o When hydrogen ion concentration is high, we expect low pH

A

ACIDEMIA

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3
Q

When blood pH is greater than the reference range (> 7.45)
o Greater than the upper limit of normal
 When blood pH is high, hydrogen concentration is low

A

ALKALEMIA

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4
Q

BUFFER SYSTEMS: REGULATION OF H+

A

BICARBONATE – CARBONIC ACID BUFFER SYSTEM

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5
Q

added into a solution in order to maintain the required pH; substance that can resist pH changes

A

Buffer

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6
Q

When an acid + bicarbonate carbonic acid system

A

HCO3- + H+ from the acid → H2CO3

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7
Q

When a base + bicarbonate-carbonic acid system

A

H2CO3 + OH group = H20 and HCO3-

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8
Q

What is the normal pH range of blood?

A

7.35 - 7.45

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9
Q

What does the Henderson-Hasselbalch equation describe?

A

The relationship between pH, bicarbonate (HCO3-), and pCO2.

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10
Q

What is the logarithmic expression for pH?

A

pH = -log [H+]

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11
Q

What does pCO2 denote?

A

Lung function.

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12
Q

What does HCO3- denote?

A

Kidney function.

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13
Q

What happens to pH when hydrogen ion concentration increases?

A

pH decreases (more acidic).

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14
Q

What happens to pH when hydrogen ion concentration decreases?

A

pH increases (more basic).

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15
Q

What organ systems regulate acid-base balance?

A

Lungs and kidneys.

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16
Q

What is the primary buffer system in the blood?

A

Bicarbonate-Carbonic Acid Buffer System.

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17
Q

How does the bicarbonate system respond to acid?

A

HCO3- binds with H+ to form H2CO3

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18
Q

How does the bicarbonate system respond to base?

A

H2CO3 dissociates into HCO3- and H+

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19
Q

It catalyzes the conversion of CO2 and H2O into H2CO3.

A

carbonic anhydrase

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20
Q

Exchange of bicarbonate (HCO3-) and chloride (Cl-) in RBCs.

A

chloride shift

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21
Q

What is another term for the bicarbonate buffer system?

A

Carbonate buffer system.

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22
Q

Why is buffering important?

A

To resist changes in blood pH.

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23
Q

What happens when CO2 increases?

A

pH decreases (respiratory acidosis).

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24
Q

What happens when CO2 decreases?

A

pH increases (respiratory alkalosis).

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25
What is the pKa of the bicarbonate buffer system?
6.1
26
How do the lungs regulate acid-base balance?
By removing CO2 through ventilation, which helps control blood pH.
27
What is the effect of hypoventilation on CO2 levels?
It increases CO2 levels, leading to respiratory acidosis.
28
What is the effect of hyperventilation on CO2 levels?
It decreases CO2 levels, leading to respiratory alkalosis.
29
How do the kidneys regulate acid-base balance?
By reabsorbing bicarbonate (HCO3-) and excreting hydrogen ions (H+).
30
What happens when bicarbonate levels increase?
It leads to metabolic alkalosis.
31
What happens when bicarbonate levels decrease?
It leads to metabolic acidosis.
32
It catalyzes the conversion of CO2 and H2O into carbonic acid (H2CO3), which then dissociates into HCO3- and H+
carbonic anhydrase
33
What is the relationship between CO2 and pH?
CO2 and pH have an inverse relationship; increased CO2 lowers pH, and decreased CO2 raises pH.
34
What happens to pCO2 and pH in chronic lung diseases?
pCO2 increases, leading to respiratory acidosis due to inadequate CO2 removal.
35
What is the primary cause of respiratory acidosis?
Hypoventilation, leading to CO2 retention
36
What is the primary cause of respiratory alkalosis?
Hyperventilation, leading to excessive CO2 removal
37
What is the primary cause of metabolic acidosis?
Excess loss of bicarbonate (HCO3-) or accumulation of acid.
38
What is the primary cause of metabolic alkalosis?
Excess retention of bicarbonate (HCO3-) or loss of acid (e.g., vomiting).
39
How does the body compensate for metabolic acidosis?
The lungs increase ventilation (hyperventilation) to expel CO2 and raise pH.
40
A condition where pH decreases due to elevated pCO2 caused by hypoventilation.
respiratory acidosis
41
What are common causes of respiratory acidosis?
COPD, respiratory depression, airway obstruction, and neuromuscular disorders.
42
A condition where pH increases due to decreased pCO2 caused by hyperventilation.
respiratory alkalosis
43
What are common causes of respiratory alkalosis?
Anxiety, fever, high altitude, and pulmonary embolism.
44
A condition where pH decreases due to a decrease in bicarbonate (HCO3-) or an increase in acid production.
metabolic acidosis
45
What are common causes of metabolic acidosis?
Diabetic ketoacidosis, lactic acidosis, renal failure, and diarrhea
46
A condition where pH increases due to excessive bicarbonate retention or acid loss.
metabolic alkalosis
47
What are common causes of metabolic alkalosis?
Prolonged vomiting, excessive diuretic use, and hypokalemia.
48
What are the primary lab findings in respiratory acidosis?
Low pH, high pCO2, and increased bicarbonate in compensation.
49
What are the primary lab findings in respiratory alkalosis?
High pH, low pCO2, and decreased bicarbonate in compensation.
50
What are the primary lab findings in metabolic acidosis?
Low pH, low bicarbonate, and decreased pCO2 in compensation
51
The body's attempt to restore normal pH by adjusting respiratory or metabolic functions.
compensation in acid-base balance
52
When pH returns to normal but CO2 and HCO3- levels remain abnormal.
complete compensation
53
When CO2 or HCO3- adjusts but pH is still outside the normal range
partial compensation
54
When there is no physiological attempt to correct pH imbalance
uncompensated acid-base disorder
55
Which organ system compensates faster, lungs or kidneys?
Lungs compensate within minutes to hours, while kidneys take hours to days.
56
What are the main lab values used to assess compensation?
pH, pCO2, and HCO3-.
57
What is the normal range for blood pH?
7.35 - 7.45.
58
What is the normal range for pCO2?
35 - 45 mmHg
59
What is the normal range for HCO3-?
22 - 26 mEq/L
60
What is the normal range for pO2?
80 - 100 mmHg
61
How is mild hypoxemia classified?
pO2 between 60 - 79 mmHg
62
How is moderate hypoxemia classified?
pO2 between 40 - 59 mmHg
63
How is severe hypoxemia classified?
pO2 less than 40 mmHg
64
What is the first step in analyzing acid-base disorders?
Check the pH to determine if it indicates acidosis or alkalosis.
65
What is the second step in analyzing acid-base disorders?
Assess pCO2 to determine if the primary cause is respiratory.
66
What is the third step in analyzing acid-base disorders?
Assess HCO3- to determine if the primary cause is metabolic
67
What is the preferred specimen for acid-base analysis?
Arterial blood
68
What anticoagulant is used for arterial blood gas (ABG) analysis?
Heparin
69
Why should ABG specimens be kept free of air bubbles?
Air bubbles can alter pO2 and pCO2 readings.
70
How should ABG samples be stored if not analyzed immediately?
On ice to slow metabolism and prevent gas changes.
71
What happens to pCO2 and pO2 if a sample is exposed to room air?
pCO2 decreases, pO2 increases, and pH increases
72
What happens to pCO2 and pO2 if a sample is left at room temperature?
pCO2 increases, pO2 decreases, and pH decreases.
73
What is the impact of clot formation in an ABG sample?
Clots can block the analyzer and affect results.
74
Why is proper mixing of ABG samples important?
To distribute heparin evenly and prevent clotting
75
To distribute heparin evenly and prevent clotting
It can lower pH by introducing excess hydrogen ions
76
What is the recommended time frame for analyzing ABG samples?
Within 30 minutes of collection
77
What are blood gas analyzers used for?
What are blood gas analyzers used for?
78
What principle do blood gas analyzers use?
Electrochemistry, measuring electrical potential or current.
79
What electrode is used for pO2 measurement?
Clark electrode
80
What electrode is used for pCO2 measurement?
Severinghaus electrode
81
What are the main methods of pH measurement in ABG analysis?
Potentiometry using a pH-sensitive electrode
82
What is the reference electrode used in pH measurement?
Silver-silver chloride electrode
83
What is the function of transcutaneous (TC) electrodes?
Continuous monitoring of pO2 and pCO2, mainly in neonates.
84
Continuous monitoring of pO2 and pCO2, mainly in neonates.
It measures current flow to determine pO2 levels
85
How does potentiometry work in blood gas analysis?
It measures voltage differences to determine pH and pCO2 levels.
86
Why are bedside blood gas analyzers useful?
They allow rapid, point-of-care testing for critical patients
87
What are the four primary acid-base disorders?
Respiratory acidosis, respiratory alkalosis, metabolic acidosis, metabolic alkalosis.
88
How do you determine if an acid-base disorder is respiratory or metabolic?
Check if the primary change is in pCO2 (respiratory) or HCO3- (metabolic)
89
What does a pH of 7.22, pCO2 of 20 mmHg, and HCO3- of 11 mEq/L indicate?
Partially compensated metabolic acidosis
90
What does a pH of 7.50, pCO2 of 48 mmHg, and HCO3- of 36 mEq/L indicate?
Metabolic alkalosis with partial compensation
91
What does full compensation mean in acid-base disorders?
pH is within normal range, but pCO2 or HCO3- is abnormal.
92
What does partial compensation mean in acid-base disorders?
pH is still abnormal, but the body is attempting to correct the imbalance
93
What is an uncorrected acid-base disorder?
pH is abnormal, and there is no compensation
94
What are the expected lab values in fully compensated respiratory acidosis?
Normal pH, high pCO2, high HCO3-
95
What are the expected lab values in fully compensated metabolic alkalosis?
Normal pH, high HCO3-, high pCO2
96
What is the role of the anion gap in acid-base interpretation?
It helps differentiate between causes of metabolic acidosis

CLINICAL CHEM 2 LEC (15 decks)

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