A &P Acid Base Exam 1

Question 1

physiological pH

Answer 1

7.4

Question 2

acidosis

Answer 2

when pH is below 7.35

Question 3

alkalosis

Answer 3

when pH is above 7.45

Question 4

buffer

Answer 4

stabilizes pH by keeping the acid/base ration consistent

Question 5

if concentration fluctuations are counteracted in such a way that resulting ratio is log (1) what is the change

Answer 5

zero

- little to no change when ratio is one

Question 6

What is in the extracellular buffering system

Answer 6

bicarbonate, plasma proteins, and phosphates

Question 7

What is in the intracellular buffering system

Answer 7

cytoplasmic proteins, phosphates

Question 8

how is the bicarbonate buffer system assessed clinically?

Answer 8

arterial blood gas test

Question 9

What does hydrogen ion concentration depend on?

Answer 9

ratio of HCO3- and Pco2

Question 10

what is HCO3- produced by

Answer 10

mainly by the RBC all the time, but when needed the kidneys can also produce some bicarbonate

Question 11

RBC combines CO2 and HCO3- by

Answer 11

carbonic anhydrase intracellularly

Question 12

normal range of bicarbonate

Answer 12

24-26 mEq/L

Question 13

How does the kidney regulate bicarbonate?

Answer 13

reabsorption of bicarbonate, production of bicarbonate, and excretion of H+

Question 14

Nearly all of the ____ in blood gets reabsorbed

Answer 14

bicarbonate

Question 15

if it is too acidic the kidneys can produce HCO3- but can not buffer so they excrete it with…

Answer 15

ammonia

Question 16

What does ammonium production from glutamine metabolism result in?

Answer 16

• excretion of more H+

- production of HCO3-

Question 17

Glutamate deamination yields…

Answer 17

alpha-ketoglutarate and ammonia

Question 18

the ammonia can attract H+ and

Answer 18

get excreted in the form of ammonium

Question 19

alpha-ketoglutarate can be further metabolized to yield…

Answer 19

CO2

krebs cycle

Question 20

someone in acidosis will have what showing up in their urine?

Answer 20

increased ammonium

Question 21

normal PCO2 levels

Answer 21

32-48 mmHg

Question 22

Examples of fixed acids

Answer 22

lactic acid and ketone bodies

Question 23

nonvolatile acids or metabolic acids are referred to as ____ and must be removed by the kidneys (not respiration)

Answer 23

fixed acids

Question 24

if you have a small fasting period like when you sleep you will have ketones in urine in the morning , but large amounts of ketones leads to …

Answer 24

an acidic situation

Question 25

a build up of fixed acids can be temporarily compensated by...

Answer 25

rapid removal of cO2

Question 26

increased Pco2 caused by decreased ventilation | compensation: cellular and renal

Answer 26

respiratory acidosis

Question 27

decrease in bicarbonate caused by either increased fixed acids or loss of bicarbonate - compensation: cellular, renal, respiratory

Answer 27

metabolic acidosis

Question 28

decreased Pco2 caused by increased ventilation | compensation: cellular and renal

Answer 28

respiratory alkalosis

Question 29

decrease in fixed acids, increase in bicarbonate | compensation: cellular, renal, respiratory

Answer 29

metabolic alkalosis

Question 30

asthma, COPD, morbid obesity, airway obstruction, over-sedation, COVID-19

Answer 30

causes of respiratory acidosis

Question 31

increased PCO2, normal or increased HCO3-, increased K+, increased Na+, decreased Cl-

Answer 31

effects of respiratory acidosis

Question 32

immediate cellular compensation for respiratory acidosis

Answer 32

anti-port exchange of H+/K+ (very limited because K+ is already most concentrated inside the cell)

Question 33

prolonged compensation for respiratory acidosis

Answer 33

renal: - production of bicarbonate with ammonium excretion - anti-port exchange H+/Na+ - increased excretion of Cl- (chloride shift to get bicarbonate)

Question 34

ketoacidosis, lactic acidosis, toxin intake renal failure, diarrhea/GI disorder

Answer 34

causes of metabolic acidosis

Question 35

decreased Pco2, decreased HCO3-, inc/dec K+, inc Na+, dec Cl-

Answer 35

effects of metabolic acidosis

Question 36

immediate metabolic acidosis compensation

Answer 36

cellular: anti-port exchange H+/K+ respiratory: Kussmaul respirations

Question 37

prolonged metabolic acidosis compensation

Answer 37

``` renal: -increased excretion of fixed acid - production of bicarb with ammonium excretion - anti-port exchange H+/Na+ - increased excretion of Cl- bone: - increased release of alkaline compounds Ca2+ in urine ```

Question 38

Anion Gap equation

Answer 38

AG = [Na+] - ([Cl-] + [HCO3-])

Question 39

Normal AG

Answer 39

9-16 mEq/L

Question 40

what is anion gap used for?

Answer 40

metabolic acidosis determination

Question 41

ketoacidosis, lactic acidosis, toxin intake, salicylate poisoning , advanced renal failure

Answer 41

metabolic acidosis with high AG

Question 42

diarrhea, other GI loss of bicarbonate, mild to moderate renal disease, dilutional

Answer 42

metabolic acidosis with normal AG

Question 43

immediate respiratory alkalosis compensation

Answer 43

cellular: antiport exchange H+/K+

Question 44

prolonged respiratory alkalosis compensation

Answer 44

renal: - decreased production of ammonium - decreased excretion of acids - increased excretion of HCO3-

Question 45

hyperventilation | - pain, anxiety, sepsis, toxins

Answer 45

causes of respiratory alkalosis

Question 46

decreased pCO2, decreased HCO3-, slight K+ decrease

Answer 46

effects of respiratory alkalosis

Question 47

vomiting, diuretics, laxative abuse, renal filtration failure, mineralcorticoids

Answer 47

causes of metabolic alkalosis

Question 48

decreased H+, inc CO2, inc HCO3-, dec K+, inc Na+, inc Cl-

Answer 48

effects of metabolic alkalosis

Question 49

metabolic alkalosis compensation: cellular

Answer 49

anti-port exchange H+/K+

Question 50

metabolic alkalosis compensation: respiratory

Answer 50

decrease in rate and depth

Question 51

metabolic alkalosis compensation: renal

Answer 51

increased excretion of HCO3- | decreased excretion of acids