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MD3002 post MSA > acid base control > Flashcards

acid base control Flashcards

1
Q

what buffers control acid base balance

A

haemoglobin
bicarbonate
carbonic acid
proteins

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2
Q

what is normal pH

A

7.35-7.45

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3
Q

what is normal O2 pp

A

12-13 kPa

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4
Q

what is normal pCO2

A

4.5 – 5.6 kPa

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5
Q

what is normal bicarbonate concentration

A

22 – 26 mmol/l

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6
Q

what is standard bicarbonate

A

used to indicate metabolic acid base balance

assumes standard temperature and CO2 pp

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7
Q

what is the first step of assessment of ABG

A

assess PO2 and oxygenation

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8
Q

what is a healthy P/F ratio

A

> 50

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9
Q

what P/F ratio indicates acute lung injury

A

> 40

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10
Q

what P/F ratio indicates ARDS

A

26.6

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11
Q

if the pH and pCO2 are changing in different directions what does that indicate

A

respiratory problem

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12
Q

if the pH and pCO2 are changing in the same direction what does that indicate

A

metabolic problem

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13
Q

if pCO2 and bicarb are moving in the same direction what does that indicate

A

compensation is occuring

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14
Q

what is the anion gap

A

the sum of routinely measured cations in
venous blood minus routinely measured
anions
([Na+] + [K+])- ([Cl-] +[HCO3-])

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15
Q

what is normal pH

A

7.35-7.45

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16
Q

what is normal O2 pp

A

12-13 kPa

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17
Q

what is normal pCO2

A

4.5 – 5.6 kPa

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18
Q

what conditions will cause lactic acidosis

A

hypoperfusion of the whole body or a part
increased anaerobic metabolism producing increased lactic acid

Severe acute hypoxia
Severe convulsions (resp arrest)
Strenuous exercise (dehydration)
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19
Q

what is standard bicarbonate

A

used to indicate metabolic acid base balance

assumes standard temperature and CO2 pp

20
Q

what is the first step of assessment of ABG

A

assess PO2 and oxygenation

21
Q

if the pH and pCO2 are changing in different directions what does that indicate

A

respiratory problem

22
Q

if the pH and pCO2 are changing in the same direction what does that indicate

A

metabolic problem

23
Q

if pCO2 and bicarb are moving in the same direction what does that indicate

A

compensation is occuring

24
Q

if pCO2 and bicarb are moving in the different directions what does that indicate

A

mixed problem

25
Q

what anions are measured

A

protein, phosphate, Cl, sulphate bicarbonate

26
Q

what cations are measured

A

Ca, Mg, K, Na

27
Q

what does an increased anion gap indicate

A

metabolic acidosis -

28
Q

what is the normal anion gap

A

16

29
Q

what conditions will cause lactic acidosis

A

hypoperfusion of the whole body or a part

30
Q

how is lactic acid broken down

A

in the liver using oxygen

31
Q

how will anions change in lactic acidosis

A

same cations
increase in unmeasured anions
decrease in bicarb

32
Q

what conditions can cause ketoacidosis

A

decreased insulin
diatbetes
alcoholic ketoacidosis
starvation

33
Q

what substances might be ingested which increase the anion gap

A

methanol

ethylene glycol

34
Q

what is Renal tubular acidosis

A

accumulation of acid due to failure of kidneys to acidify the urine
normal anion gap

35
Q

how does the anion gap change in renal failure

A

increase

36
Q

what conditions involve acidosis but no anion gap

A

diarrhoea

renal tubular acidosis

37
Q

how is the ionogram changed with metabolic acidosis but an unchanged anion gap

A

decreased bicarbonate only due to it being combined with H+

38
Q

how does the kidney correct metabolic acidosis

A

secretes more acid into the urine

makes new bicarbonate

39
Q

what is Kussmaul respiration

A

laboured, deep rapid pattern of breathing

40
Q

what is the most common cause of metabolic alkalosis

A

loss of H+ ions from the stomach or kidney

e.g. pyloric stenosis

41
Q

what diuretics can cause loss of H+ ions

A

furosemide

thiazide

42
Q

what can cause loss of H+ ions in babies

A

pyloric stenosis

43
Q

what to situations lead to metabolic alkalosis

A

an initiating process and a maintaining process

44
Q

how is alkalosis maintained

A

kidneys ability to excrete excess bicarb is impaired

45
Q

what is chloride depletion

A

if chloride is low in the kidneys then bicarb must be reabsorbed leading to alkalosis

MD3002 post MSA (66 decks)

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