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Clinical Chemistry > Acid-Base Balance > Flashcards

Acid-Base Balance Flashcards

1
Q

Buffer

A

combination of a weak acid or weak base and its salt

resists pH changes

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2
Q

Acidosis

A

pH < 7.35

describes the process that leads to an decreased blood pH

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3
Q

Acidemia

A

describes the state of low blood pH

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4
Q

compensation vs correction

A

compensation, a metabolic or respiratory change outside of the normal range to compensate for acidosis or alkalosis
correction is intervening action to return the blood pH to the proper range

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5
Q

Oxidative Metabolism

A

uses O2 at the mitochondrial level to metabolize nutrients and turn them into ATP & waste products

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6
Q

normal blood range pH

A

7.34- 7.44

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7
Q

If H+ was not regulated the acid environment would damage:

A

metabolic processes
alter consciousness
increase neuromuscular irritability
coma, death

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8
Q

Buffer systems (4)

A

bicarbonate-carbonic acid buffer
hemoglobin buffer system
proteins as buffers of H+ (usually only in cells)
phophate buffer - only for the kidneys

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9
Q

Major organs involved in acid-base maintenance

A

Kidney & Lungs

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10
Q

Bicarb-Carbonic Acid Buffer general characteristics

A

h2co3 dissociates into co2 & h20 allowing co2 to be eliminated by lungs & H+ to leave as water through the kidneys

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11
Q

correction to bicarb-carbonic acid system

A

changes in co2 modify the ventilation rate of the lungs

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12
Q

compensation of bicarb-carbonic acid system

A

hco3- concentration can be altered by the kidneys

this system also binds H+ when it appears

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13
Q

Bicarbonate- carbonic acid buffer system equation

A

co2 + h2o h2co3 H+ + hco3-

reaction is reversible

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14
Q

formula to calculate carbonic acid

A

pCO2 x 0.0307

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15
Q

tCO2 component

A

carbonic acid + bicarbonate (90%)

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16
Q

carbonic acid molecular formula

A

H2CO3

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17
Q

bicarbonate ion molecular formula

A

HCO3-

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18
Q

pH calculation

A 
pKa + log salt/acid
pKa - always use 6.1 during these calculations
acid- carbonic acid
salt - bicarbonate
normal ratio is around 20/1
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19
Q

pCO2 range interpretation

A

respiratory associated
range 35-45 mmHg
lower than range = alkaline
higher than range = acidosis

20
Q

tCO2 range interpretation

A

metabolic associated
range 23-29 mmol/L
lower than range = acidosis (loss of bicarb ion)
higher than range = alkaline (increase of bicarb ion)

21
Q

Lung involvement

A

exhale co2, inhale o2
1st line of defense for acid-base disorders
quick effect on acid-base

22
Q

Kidney involvement

A

reclaims hco3-
produces more hco3- if needed & takes several days to correct a hco3- deficiency
long term compensation

23
Q

factors affecting increased levels hco3-

A

when hco3- is increased we excrete hco3-

retain it when compensating lung disease & when cl- loss exceeds what is needed for electrical neutrality

24
Q

factors affecting decreased levels of hco3-

A

diuretics
reduced absorption when there is loss of cations
when kidney is not functioning (nephritis, infections)

25
Q

Acid-base disorders

A

respiratory acidosis
respiratory alkalosis
metabolic acidosis
metabolic alkalosis

26
Q

metabolic acidosis (non respiratory )

A

decreased hco3- ( bicarb ion)
increase in acids= ketoacidosis
decrease in acid excretion= renal tubular acidosis, diarrhea, loss of bicarb ion

27
Q

respiratory acidosis

A 
increased pCO2 ( increase in carbonic acid bc lungs cant get rid of co2)
COPD: chronic obstructive pulmonary disease, hypoventilation
CHF
28
Q

most common causes of metabolic acidosis

A

ketoacidosis, shock, severe diarrhea, impaired kidney function

29
Q

metabolic alkalosis

A

increased hco3- (bicarb ion)
ingestion of bicarb producing salts
disease: diuretic therapy, vomiting, nasogastric suction

30
Q

respiratory alkalosis

A

decreased pCO2
more common
missing H+
hypoxia from drugs like salicylates or increased temp due to fever, hysteria, pulmonary embolism, pulmonary fibrosis
breathing into paper bag to correct - increase lvl of carbonic acid by breathing co2 rich air

31
Q

Oxygen transport

A

transported by hemoglobin
sigmoidal curve due to affinity of o2 & hem
after 1 o2 attaches, the affinity for other o2 is increased & same in the reverse
see release of o2 when po2 is 60 mmHg or less

32
Q

oxygen at lung level is influenced by :

A 
alveolar destruction
pulmonary edema
airway blockages
inadequate blood supply
rate of diffusion of co2 from blood & diffusion rate of o2 out of lung
33
Q

oxygen transport in hemoglobin is influenced by :

A 
[co]
pH
temp of blood
[pco2]
2,3 DPG in RBC
presence of non-functioning hemoglobin
34
Q

left shift in o2 saturation curve

A

^ o2 saturation & v pco2

^ pH ( v H+), v 2,3 DPG, v temp

35
Q

right shift in o2 saturation curve

A

v o2 saturation % ^pco2

^ pH (^H+), ^ 2,3 DPG, ^ temp

36
Q

if a sample is not on ice what will be increased?

A

pCO2

37
Q

if a sample is correctly & anaerobically collected but is not processed immediately what will be abnormal?

A

incrased p02 from the leching of hemoglobin

38
Q

low end of pco2

A

respiratory alkaline
loss of carbonic acid
v h2co3

39
Q

high end of pco2

A

respiratory acidosis
increase carbonic acid
^ h2co3

40
Q

low end of tco2

A

metabolic acidosis
loss of bicarb ion
v hco3-

41
Q

high end of tco2

A

metabolic alkalosis
increase of bicarb ion
^ hco3-

42
Q

Measurements of blood gases

A

pH potentiometric
pCO2: modified pH electrode thatm easures dissolved co2
pO2: amperometrical electrode

43
Q

Errors in electrode measurements

A

protein build up on the ISE membrane **
bacterial contamination of inner electrode solutions
incorrect calibration of the ISE

44
Q

Calibration of blood gas analyzers

A

always 37 C temp
2 different pH buffer solutions to calibrate
2 gas mixtures to calibrate pCO2 & pO2

45
Q

Specimens for blood gases

A 
collected in heparin*
placed on ice* 
collected anaerobically*
processed immediately **
otherwise metabolism will continute to occur in the tube & will generate additional H+ & p02

Clinical Chemistry (23 decks)

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