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CLINICAL CHEMISTRY > Acid-Base Balance > Flashcards

Acid-Base Balance Flashcards

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1
Q

yield hydrogen ion (H+) or hydronium ion when dissolve in water

A

Acid

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2
Q

yield hydroxyl ion

A

Base

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3
Q

relative strength of an acid and base ; ability to dissociate in water

A

K value or ionization constant

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4
Q

Negative log of ionization constant

A

pKa

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5
Q

Combination of weak acid and weak/conjugate base; prevents changes in pH

A

Buffer

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6
Q

Principle Buffer System:

A

Bicarbonate-Carbonic Acid System (pKa of 6.1)

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7
Q

Buffer Reference Value

A

7.40 H+ or 40 mmol/L

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8
Q

Major Buffer System (4)

A

Bicarbonate -Carbonic Acid
Protein Buffer
Phosphate Buffer
Hemoglobin Buffer System

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9
Q

Principle Buffer System of the Body

A

Bicarbonate-Carbonic Acid Buffer System

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10
Q

H2CO3 (Weak Acid)

A. Releases Hydrogen ion
B. Do not release ion

A

B. Do not release ion

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11
Q

It carries both acidic and basic charge to be able to find or release excess hydrogen

A

Protein Buffer System

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12
Q

present in plasma proteins which are NEGATIVE in charge and capable of binding with H+

A

Imidazole groups of histidine

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13
Q

Buffer System by which excess H+ combines in renal tubules with Na2PO4

Sodium is reabsorbed and H+ is passed in urine

A

Phosphate Buffer System

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14
Q

Plays a role in plasma and RBC involved in exchange of sodium ion in the urine H+ filtrate

A

Phosphate Buffer System

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15
Q

Amino acid that produces NH3

A

Glutamine

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16
Q

Excreted form of ammonia in urine

A

NH4

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17
Q

Decreased pH = ____ NH3

A

Increased NH3

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18
Q

Inability to produce acidic urine

A

Renal Tubular Acidosis

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19
Q

Type of Renal Tubular Acidosis that is characterized with defective H+ secretion

A

Type I (Distal RTA)

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20
Q

Type of RTA with reduced reabsorption of HCO3

A

Type II (Proximal RTA)

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21
Q

Type of RTA with decreased ammoniagenesis

A

Type IV RTA

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22
Q

Buffer system involves CO2 combining with H2O forming H2CO3 by CARBONIC ANHYDRASE found in RBC then dissociates into HCO3+

A

Hemoglobin-Oxyhemoglobin Buffer System

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23
Q

Oxygen Dissociation Curve:

Shift to the ___: Acidosis

A

Right

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24
Q

Oxygen Dissociation Curve:

Shift to the ___: Alkalosis

A

Left

25
Q

Organs Associated in Maintaining pH

A

Lungs and Kidneys

26
Q

Reference range of Acid-Base Balance

A

35 to 45 mmol/L

27
Q

Main role to regulate H+

A

Bicarbonate + Carbonic Acid System

28
Q

Two Components: Bicarbonate and Carbonic acid

A
  1. Bicarbonate
  2. Carbonic Acid
29
Q

Bicarbonate

HCO3 —> H + HCO3 = H2CO3

A

Basic pH

30
Q

Carbonic acid

H2CO3 –> H2CO3 + OH = HCO3 + H2O

A

Acidic pH

31
Q

HCO3 to H2CO3 ratio

A

20:1

32
Q

pKa = pKa + log A/HA

A

Henderson-Hasselbach Equation

33
Q

Regulates pH by retention or elimination of CO2 by changing the rate and volume of VENTILATION

A

Lungs (Respiratory)

34
Q

Represented by pCO2 (H2CO3)

A

Lungs

35
Q

Hypoventilation - ____ CO2

A

Increased CO2 : Acidosis

36
Q

Hyperventilation - ____ CO2

A

Decreased CO2 - Alkalosis

37
Q

Regulates pH by excreting acid, primarily ammonium ion and reclaimingHCO3 from glomerular filtrate

A

Kidney

38
Q

Represented by HCO3

A

Kidney (Metabolic)

39
Q

IV Infusion of lactate, acetate and HCO3

Excess chloride (sweating, vomiting, prolonged nasogastric suction)

A

Increased HCO3

40
Q

Use of diuretics
Excessive loss of cations
Kidney dysfunction like chronic nephritis

A

Decreased HCO3

41
Q

Increased pCO2

Observed in Chronic Obstructive Pulmonary Disease (COPD)

Emphysema, Asthma
Myasthenia gravis
Barbituates, Morphine, Alcohol
Asphyxiation
Congestive Heart Failure (CHF)

A

Primary Respiratory Acidosis

42
Q

Hyperventilation
Hysteria
Hypoxia
Salicylates
Increase Environmenal Temperature
Pulmonary Emboli, Fibrosis
Hepatic Cirrhosis
Asipirin Overdose

A

Primary Respiratory Alkalosis

43
Q

Excess administration of sodium bicarbonate

Ingestion of bicarbonate producing salts such as lactate, citrate and acetate

loss of acid due to VOMITING

A

Primary Metabolic Alkalosis

44
Q

Specimen needed for Acid-Balance and Blood-Gas Test

A

Arterial Blood (warmed @45 dec for 5 minutes)

45
Q

Sample taken for pH and CO2

A

Venous blood (w/o tourniquet & clenching)

46
Q

Dead space in the needle should be filled with sterile

A

Anticoagulant (Heparin)

47
Q

Samples are placed in ___

A

Ice (Slurry Ice)

48
Q

For every 20 minutes delay the pH lowers

A

0.01

49
Q

Blood Gas Analysis routinely made @37c

For each grade of Fever in the patient:

A

pO2 will fall by 7%
pCO2 will rise by 3%
pH will decrease by 0.015

50
Q

Measured by Blood Gas Instrument (3)

A

pH
pCO2
pO2

51
Q

Instrument to Measure:

pH

A

Potentiometry
Sands Electrode

52
Q

Instrument to Measure:

Silver-Silver Chloride
Calomel (HgCl2) is a reference method for

A

pH

53
Q

Instrument to Measure:

pCO2

A

Clark Electrode (Polarography/Amperometry)

54
Q

Instrument to Measure:

pO2

A

Severinghaus Electrode (Potentiometry)

55
Q

Total CO2 Content:

HCO3 is converted to oxaloacetic acid by PHOSPHOENOLPYRUVATE CARBOXYLASE

measured spectrophotometrically
(malate –> malate dehydrogenase)
NADH ; UV Light Chromogen

A

Automated Enzymatic Method

56
Q

Total CO2 Content:

Use of Silicone-rubber gas dialysis membrane

Cresol res at pH 9.2

Buffered Cresol Red Solution

Decrease in Color Intensity is proportional to CO2 content

Spectrophotometer at 430 nm

A

Automated Colorimetric Method

57
Q

Total CO2 Content:

Pulse oximeter principle

A

Photometry

58
Q

Total CO2 Content:

Based on red and Infrared Light

A

Pulse Oximeter

CLINICAL CHEMISTRY (29 decks)

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