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GERR > Pathophysiology - Pathophysiology of Acid- Base status > Flashcards

Pathophysiology - Pathophysiology of Acid- Base status Flashcards

1
Q

which of these substances is a product of cell respiration and is excreted by the lungs

a.carbonic acid
b.non carbonic acid

A

a.carbonic acid

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2
Q

which of these substances is a product of cell metabolism and is excreted by the kidneys

a.carbonic acid
b.non carbonic acid

A

b.non carbonic acid

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3
Q

which of these states occurs due to asthma attack

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

a. acute respiratory alkalosis

bronchostriction
hypoxia and hypocapnia
low co2 , normal HCO3 - as compensation not activated yet = alkali pH

so acute resp alkalosis - from fletchly diagram
(blue line on fletchley)

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4
Q

which of these states occurs due to acute hyperventilation

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

a. acute respiratory alkalosis

anxiety = increased ventilation
blow of co2 quickly so hypocapnia
low co2, normal hco3 as compensation not yet activated

acute resp alkalosis

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5
Q

which of these states occurs during chronic kidney disease

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

e.metabolic acidosis

failure to excrete H+ and failure to reabsorb HCO3-
due to failure to excrete K+ , hyperkalaemia, K+ displaces the H+ in cells and H+ in blood increases so acidic blood
low HCO3- and low CO2 ,acidic blood (high anion gap)
= metabolic acidosis

treated with bicarbonate/ diet change/ transplant

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6
Q

which of these states occurs in renal tubular acidosis

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

e.metabolic acidosis

type 1 = failure to secrete hydrogen ions @ DCT
cannot make bicarbonate
less bicarbonate in the blood
treated with bicarbonate

type 2 =failure to reabsorb bicarbonate @ PCT
less bicarbonate in blood
treated with high dose bicarbonate

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7
Q

which type of renal tubular acidosis is caused a failure to secrete hydrogen ions at the distal convuluted tubule leading to less bicarbonate being made and less bicarbonate being reabsorbed into the blood

a.type 1
b.type 2

A

a.type 1

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8
Q

which type of renal tubular acidosis is caused by a failure to reabsorb bicarbonate at the proximal convuluted tubule

a.type 1
b.type 2

A

b.type 2

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9
Q

which of these states occurs in COPD

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

hypoxia, hypercapnia
high co2 , high HCO3 = chronic respiratory acidosis
treated with bronchodilators, inhaled steroids controlled oxygen therapy in exacerbations
following treatment - post hypercapnic metabolic alkalosis

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10
Q

which of these states is complication of mechanical ventilation in patients with a COPD exacerbation

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

f.metabolic alkalosis

co2 returns to normal, compensatory high HCO3- remains
post hypercapnic metabolic alkalosis

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11
Q

which of these states occurs in diarrhoea

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

loss of fluids and bicarbonate
hypokalameia , less H+ displaced from cells so blood alkali
metabolic alkalosis
treat with fluids and electrolytes

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12
Q

which of these states occurs in vomiting

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

f.metabolic alkalosis

loss of stomach acid
hypokalemia
hypovolaemia
hyperaldosteronism
more bicarbonate reabsorbed for H+ lost

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13
Q

what state occurs in hyperaldosteronism

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

f.metabolic alkalosis

more H+ secretion from tubule
more bicarbonate made and resorbed
hypokalaemia, so more H+ in cells less in blood
metabolic alkalosis

treatment = adrenalectomy

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14
Q

what state occurs in hypoaldosteronism

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

less H+ secreted
less bicarbonate made and less resorbed
hyperkalaemia , H+ displaced from cells into blood

treatment = aldosterone

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15
Q

which of these states occurs in hepatocellular dysfunction

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

c.chronic respiratory alkalosis
abnormal toxin levels stimulate resp centre, breathe off more
CO2,
low CO2, low HCO3- = chronic respiratory alkalosis

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16
Q

which of these states occurs in diabetic ketoacidosis

a. acute respiratory alkalosis
b.acute respiratory acidosis
c.chronic respiratory alkalosis
d.chronic respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

fatty acid metabolism makes acetone and acetylacetate acidic
and causes hyperkalaemia as potassium lost from cells
so metabolic acidosis

tretament = insulin, fluids, bicarbonates and electrolytes

17
Q

hyperventilation, hypoxia, asthma, liver disease , heart failure and aspirin can all lead to what state

a. respiratory alkalosis
b.respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosi

A

a. respiratory alkalosis

18
Q

hypoventilation, COPD, morphine and barbituates can all lead to which state?

a. respiratory alkalosis
b.respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

b.respiratory acidosis

19
Q

vomiting, hyperaldosteronism, hypovolaeia, post hypercapnia, alkali ingestion, diuretics and hypokalaemia can all lead to which state?

a. respiratory alkalosis
b.respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

f.metabolic alkalosis

20
Q

renal tubular acidosis and diarrhoea (normal anion gap) , chronic renal disease , lactic acidosis, ketoacidosis ,liver disease (high anion gap) can all lead to which state?

a. respiratory alkalosis
b.respiratory acidosis
e.metabolic acidosis
f.metabolic alkalosis

A

e.metabolic acidosis

GERR (53 decks)

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