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Chem/Physics- Hannah > Test 2- Last Minute Concept Check > Flashcards

Test 2- Last Minute Concept Check Flashcards

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1
Q

Base excess tells us

A

Quantifies the metabolic acidosis

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2
Q

Anion gap tells us

A

The source of metabolic acidosis

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3
Q

Base excess is the sum of:

A

Weak acids: phosphate, bicarbonate, plasma proteins, and hemoglobin

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4
Q

Strong acids include:

A

Lactic acid
Keto acid
Sulfate

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5
Q

What is the definition of base excess?

A

How much strong acid is needed to return our body to “normal” conditions (pH 7.40, CO2 40, 37 degrees C)

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6
Q

What is the base excess of blood at a pH of 7.40, CO2 of 40, and temperature of 37?

A

0 b/c this is the definition of base excess

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7
Q

What is base excess a useful predictor for?

A

Severity of critical illness associated with hypovolemic shock and consequent metabolic acidosis

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8
Q

What increases anion gap?

A

Loss of bicarbonate or increased production of strong or weak acids

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9
Q

What happens with mud piles?

A

We have an increase in strong and weak acids and a decrease in bicarbonate

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10
Q

How does fusedcars affect anion gap?

A

Decreased bicarb and increased chloride result in a normal anion gap
-drugs that impair renal metabolism
-endocrine loss of H2PO4 and Na
-saline administration where Cl- forces HCO3- intracellularly to maintain electro neutrality
- HCO3- neutralizes stomach acid and is reabsorbed into intestine
GI pathologies allow loss of bicarb and decreased renal bicarb/Cl- exchange

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11
Q

Why pH is important to physiology?

A
  • can alter enzymatic activity
  • ionization of drugs and proteins
  • hydrogen ions are involved in nearly all biochemical reactions
  • can affect movement of certain molecules in and out of cells
  • changes in ventilation, perfusion, and electrolyte composition can rapidly alter [H+] and the acid-base balance
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12
Q

Non-carbonic buffers include:

A

Plasma proteins
Hemoglobin
Phosphate

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13
Q

What are the general physiological effects of acidemia?

A

-direct depressant effects predominate with worsening acidosis
Myocardial and smooth muscle depression: decreased contractility, decreased SVR, hypotension, less responsive to endogenous catecholamines, decreased threshold for crib
-pulmonary vasoconstriction
-bronchodilation
-tissue hypoxemia despite rightward shift of oxyhemoglobin curve
-hyperkalemia—>dysrythmias
-CNS depressant effect- increased CBF and intracranial HTN leading to CO2 narcosis

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14
Q

Physiological effects of alkalosis

A

Oxyhemoglobin curve shifts left so harder to drop off O2
-hypokalemia (less steep change than acidemia)
-increased number of binding sites on plasma proteins for Ca2+ so decreased Ca2+
Circulatory depression
Neuromuscular excitability
-decreased CBF
-increased SVR
-can precipitate coronary vasospasm
-decreased pulmonary vascular resistance
-increased bronchial smooth muscle tone
-bronchial constriction

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15
Q

Renal compensation during acidosis:

A

Increased reabsorption of bicarb
Increased creation of bicarb
Increased excretion of H+
Increased production of ammonia

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16
Q

A Negative Urine anion gap implies

A

GI loss of bicarb

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17
Q

Anesthetic considerations with acidemia

A
  • can make CNS depressant effects of sedatives and anesthetics exaggerated
  • increased sedation and depression of airway reflexes
  • circulatory effects can be exaggerated
  • agents that decrease sympathetic tone can produce circulatory depression
  • don’t give succ
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18
Q

Anesthetic considerations with alkalosis

A
  • prolongs duration of opioid induced respiratory depression
  • general ischemia with marked reduction in CBF in presence of hypotension
  • can precipitate dysrhythmias
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19
Q

What is the currency of force?

A

Energy

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20
Q

What is energy?

A

The capacity do to work and is quantified as the amount of work done per unit time
Energy= work/time = joules/time= watts

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21
Q

What is force?

A

That which changes or tends to change the state of rest or motion of an object
Force= mass x acceleration

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22
Q

How is force measured?

A

Newtons (m/s2), dynes (cm/s2), and Joules (m2/s2)
Newton is the force that will accelerate a mass of 1 kg, 1 meter/sec2
Dyne is the force that will accelerate a mass of 1 gm, 1 cm/sec2
Joule= unit of energy or a unit of work

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23
Q

The internal energy is

A

The sum of all the potential and kinetic energy in the particles within a system

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24
Q

Potential energy is

A

The stored capacity of a body or system to do work
Potential energy= mass x gravity x height
Energy stored for later use

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25
Q

Kinetic energy is

A

The inherent energy in the motion of a body

KE= m x v2/2

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26
Q

Resistance is (definition)

A

A passive force exerted in opposition to another and active force
Delta P= F x R
Takeaway: resistance is directly proportional to pressure drop

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27
Q

Forces related to resistance:

A

Friction-caused by adhesive and cohesive forces
Produces resistance to flow in a tube
Viscosity: a measure of fluids internal resistance (cohesive force) to flow

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28
Q

Definition of pressure

A

Force exerted by atoms and molecules

Is the force applied to an object over its surface area

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29
Q

Measurement of pressure

A

Pressure= force/area

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30
Q

How does density affect pressure?

A

Increased density increases pressure

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31
Q

What is the relationship between pressure, flow, and distance?

A

Delta P= flow x resistance

32
Q

Pascal’s law

A

When external pressure is applied to a confined fluid, it is transmitted to every point within the fluid

33
Q

Ambient vs atmospheric pressure

A

Atmospheric pressure- pressure is present whether it contacts an issue object or not
If an object is sitting out in room air then ambient pressure=atmospheric pressure
Ambient pressure is the pressure of the medium that is actually in contact with the object (think of a diver underwater)

34
Q

What kind of flow occurs through an orifice?

A

Turbulent

35
Q

Explain LVP

A

Laminar flow is inversely proportional to viscosity (Pouiseuille’s law)

36
Q

Explain Graham’s touchdown

A

Turbulent flow in inversely proportional to density using Graham’s law

37
Q

Bernoulli’s theorem

A

In a tube of varying diameter, a decrease in diameter results in an increase in velocity

38
Q

What is the boiling point?

A

Temperature at which the vapor pressure of a liquid equals the ambient pressure… the entirety of the liquid enters the gas phase
Vapor pressure is directly proportional to temperature and inversely proportional to IMF

39
Q

What is vaporization?

A

Conversion of a volatile liquid to a vapor/gas

Process by which particles escape from the surface of a liquid

40
Q

Saturated vapor pressure

A

When as many molecules return to the liquid as escape from it, the atmosphere above the liquid is said to be saturated

41
Q

Vapor pressure definition

A

The vapor pressure is the pressure exerted by vapor particles in equilibrium with their associated liquid akin to a few receptors jumping into the constitutive state, a few liquid molecules vaporize but the liquid is not boiling

42
Q

Dew point definition

A

Temperature at which if a volume of air is cooled, moisture precipitates out
When air is more loaded with water vapor, more likely for some water to condense out
(A higher dew point means there is more water in the air)

43
Q

Is vapor pressure affected by atmospheric pressure?

A

No! It is the same regardless of atmospheric pressure but the boiling point would be lower as atmospheric pressure is lower

44
Q

What does vapor pressure depend on?

A

Temperature (increased temp increases VP)
Polarity (increased polarity decreases VP)
Mass (increased mass decreased VP)

45
Q

What is the vapor pressure of water at room temperature of 20 degrees?

A

17.5 mmHg

46
Q

What is the vapor pressure of water at 37 degrees (body temp)?

A

47 mmHg

47
Q

Latent heat of vaporization

A

Amount of heat absorbed to convert a liquid to a gas at its boiling point
Water takes a lot of energy to get to its boiling point so it has a high latent heat of vaporization

48
Q

Difference between heat and temperature

A

Heat is the total kinetic energy of the molecules of a substance and is a form of energy that can be transferred from a hotter substance to a cooler substance

Temperature is the average kinetic energy of the molecules of a substance… the thermal state of a substance which determines whether it will give heat to another substance or receive heat from another substance

49
Q

Definition of conduction

A

Heat transferred from one point to another by direct contact

50
Q

Definition of convection

A

Heat transfer that occurs when a fluid flows over a solid whole temperature between the fluid and solid are different

51
Q

Definition of radiation

A

The transfer of heat through divergence in all directions from a center

52
Q

Define Evaporation

A

The transfer of heat through converting a liquid to a vapor

53
Q

Reynolds number is a ratio of

A

Inertial forces/cohesive forces

54
Q

Reynolds number is

A

Velocity x diameter x distance/viscosity

55
Q

When discussing solvents and solutes

A

Solvent molecules must surround solute molecules in a solution

56
Q

How does temperature affect the solubility of a solid?

A

Increased temperature typically increases solubility of a solid but we have endothermic and exothermic so there is a caveat

57
Q

How does temperature affect a gas?

A

Increased temperature, decreased solubility

58
Q

Nature of the solvent affects

A

The amount of solid that dissolves

Think water and alcohol… water is more polar than ethanol so it dissolves polar substances better than ethanol

59
Q

Henry’s law definition

A

Amount of a gas dissolved in a liquid is directly proportional to the pressure applied to the gas as it overlies the liquid
More pressure = more likely gas molecules will bounce down into liquid

60
Q

Henry’s law relationships

A

Increased Kh= decreased solubility

Increased pressure = increased solubility

61
Q

What is a saturated solution?

A

The state of a solution in which more solute cannot be added without some of the solute precipitating out of the solution (or vaporization for out of the solution)
The point of equilibrium between the gas and liquid phase (gas solute)

62
Q

% solution calculation 0.9% Na

A

9 grams/1L so it is 0.9 per 100 mL

63
Q

Molar solution with .9 given Mw of NaCl = 58 grams/mole

A

9/58 grams/mole = 0.16 moles/1 L so 0.16 Molar

64
Q

Graham’s law definition

A

Describes movement of GAS from one compartment to another through a porous membrane (diffusion) or small opening (effusion)

65
Q

Graham’s law calculation

A

Diffusion coefficient= solubility of gas/ square root of molecular weight

66
Q

What is Fick’s law definition?

A

Describes the volume of a gas that diffuses across a membrane per minute
Diffusion rate= area x diffusion coefficient x delta P/thickness

67
Q

What is a Bunsen solubility coefficient?

A

Expressed as a numerical value for a particular gas in a given liquid it defined the volume of a gas in a unit volume of liquid at 0 degrees and 760 mmHg
So if we have 4.9 volumes of O2 in 100 mL H20 then we have 0.049 mL of O2 in 1 mL H20

68
Q

What is the Ostwald solubility coefficient?

A

Defined as the ratio of the volume of a gas absorbed to the volume of solvent at the temperature and pressure of the experiment

Used to express the blood/gas and tissue/gas ratio

69
Q

What is tension?

A

Used to express the concentration of a gas in a mixture

Means the same thing as force or pressure

70
Q

What is surface tension?

A

Created at the interface between a liquid and gas where the liquid molecules are pulled together by cohesive forces

71
Q

Define the Law of Laplace

A

Defines the pressure gradient across the wall of a sphere or cylinder which are related to wall tension and radius
T= pressure x radius (cylinder)
2T= pressure x radius (sphere)

Pressure is inversely proportional to radius since tension is constant in the body

72
Q

Surface tension and ventilation… why would smaller alveoli that have a larger pressure than larger alveoli be a problem?

A

Small would empty into large and small would collapse making them harder to open… not a problem because of surfactant!

73
Q

How does Poiseueille’s law relate to resistance?

A

Resistance= viscosity x length/ radius x delta P

Applies to laminar flow

74
Q 
Applications of Poiseueille’s law? 
Lower needle gauge 
Shorter needle length 
Increased hydrostatic pressure 
Polycythemic patient 
Anemic patient
A 
1 increases flow
2. Increases flow 
3. Increases flow
4. Decreased flow
5 decreased flow
75
Q

When does flow become turbulent?

A

Velocity of flow is high
Tube narrows, has kinks, or angles
Wall of the tube is rough
Fluid flows through an orifice

Chem/Physics- Hannah (9 decks)

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