Acid-Base Balance

Question 1

Normal pH is…

Answer 1

7.4

Range of 7.35 to 7.45

Question 2

Acid-base disturbances are associated with…

Answer 2

Significant morbidity and mortality

Question 3

If pH is less than 7.4, the patient is in…

Answer 3

Acidosis

Question 4

If pH is above 7.4, the patient is in…

Answer 4

Alkalosis

Question 5

These organs are primarily responsible for maintaining acid-base homeostasis…

Answer 5

Lungs and kidneys

Question 6

The lungs regulate pH via ____, which is…

Answer 6

Carbon dioxide - acidic

Question 7

The kidneys regulate pH via ____, which is…

Answer 7

Bicarbonate - basic

Question 8

The lungs adjust ____ to…

Answer 8

CO2 - increase/decrease PaCO2 based on pH

Question 9

The lungs are able to make adjustments to PaCO2…

Answer 9

Relatively quickly within minutes - via respiratory rate

Question 10

The kidneys adjust ____ to…

Answer 10

Bicarbonate excretion - increase/decrease bicarb levels based on pH

Question 11

Compared to lung speed, the kidneys response to acid-base changes…

Answer 11

Is slower - days

Question 12

Metabolic acidosis is defined by…

Answer 12

pH below 7.4
Decreased serum bicarbonate

Question 13

Compensation for metabolic acidosis is…

Answer 13

Respiratory - decrease PaCO2

Question 14

Metabolic acidosis may be due to…

Answer 14

Accumulation of acidic anions (lactic acidosis)
Disturbance of endogenous H+/HCO3-

Question 15

Treatment of metabolic acidosis is primarily…

Answer 15

Identifying + correcting cause
Bicarbonate administration

Question 16

Metabolic alkalosis is defined by…

Answer 16

pH above 7.4 & elevated serum bicarbonate

Question 17

Most common causes of metabolic alkalosis include…

Answer 17

Loss of gastric acid due to vomiting

Loss of intravascular volume/chloride due to diuretics

Iatrogenic - improper anion balance in parenteral nutrition, or overcorrection of metabolic acidosis with bicarbonate

Question 18

Treatment of metabolic alkalosis is…

Answer 18

To correct underlying factors
Volume repletion with norma saline
Carbonic anhydrase inhibitors - increase serum carbonic acid levels

Question 19

Respiratory alkalosis is defined as…

Answer 19

pH above 7.4 and decreased PaCO2

Question 20

If respiratory alkalosis is acute, serum bicarbonate…

Answer 20

Will still be normal (metabolic compensation occurs slowly)

Question 21

If respiratory alkalosis is chronic, serum bicarbonate…

Answer 21

Will be decreased to compensate

Question 22

Respiratory alkalosis occurs physiologically in…

Answer 22

Pregnancy
Individuals living at high altitudes

However commonly seen in hospitalized patients

Question 23

Most common causes of respiratory alkalosis include…

Answer 23

Central stimulation of respiration (anxiety, pain)
Hypoxemia or tissue hypoxemia
Peripheral stimulation of respiration

Question 24

Respiratory alkalosis is treated by…

Answer 24

Identifying and correcting the underlying cause

Question 25

Respiratory acidosis is defined by...

Answer 25

pH below 7.4, and increased PaCO2

Question 26

If respiratory acidosis is acute, serum bicarbonate...

Answer 26

Will still be normal

Question 27

If respiratory acidosis is chronic, serum bicarbonate...

Answer 27

Will be increased to compensate

Question 28

Causes of acute respiratory acidosis may be from...

Answer 28

Central (drugs, infection, stroke) Perfusion abnormalities Airway and pulmonary abnormalities

Question 29

Chronic, compensated respiratory acidosis may not require...

Answer 29

Treatment

Question 30

Acute respiratory acidosis treatment focuses on...

Answer 30

Increasing tissue oxygenation to address severe hypoxia Treating underlying causes