Acid-Base Balance

Question 1

Enumerate organ systems

involved in the acid-base balance;

Answer 1

Respiratory & excretory test

Question 2

Strong acids: pKa values

Answer 2

3.0

Question 3

Strong bases: pKa values > __

Answer 3

9.0

Question 4

Identify: most important buffer system

when it comes to acid-base balance

Answer 4

Bicarbonate buffer system

Question 5

Which is true?
A. For acids, raising the pH above the pKa will cause the acid to dissociate and yield an H+
B. For bases, lowering the pH below the pKa will cause the base to release OH−
C. BOTA
D. NOTA

Answer 5

C

Question 6

Effectiveness of buffer depends on the ff, except:
A.pKa of the buffering system
B.pOH of the substance
C.pH of the environment in which it is placed
D.NOTA

Answer 6

B

Question 7

Which are extracellular buffers?
A. bicarbonate 
B. proteins
C. ammonia
D. phosphate

Answer 7

A and C

Question 8

Which are intracellular buffers?
A. bicarbonate 
B. proteins
C. ammonia
D. phosphate

Answer 8

B and D

Question 9

has more immediate effect in terms of buffering
A.Respiratory System
B.Renal System
C.NOTA

Answer 9

A

Question 10

normal extracellular H+ value: identiify

Answer 10

36 to 44 nmol/L

Question 11

Which is not a consequence of abnormal extracellular H+ value?
A.altered consciousness
B.neuromuscular irritability
C.tetany
D.abdominal pain

Answer 11

D

Question 12

true about bicarbonate buffer system
A.H2CO3 dissociates into CO2 and H2O, allowing CO2 to be eliminated by the lungs and H+ as water
B.changes in CO2 modify the functional rate of kidneys
C.HCO3- concentration can be altered by the lungs

Answer 12

A

B - modify ventilation rate dapat
C - by kidneys dapat

Question 13

Bicarbonate buffer system immediately counters the effects of:
A. ketone bodies 
B. lactic acid
C. non-volatile acids
D. AOTA

Answer 13

D

Question 14

What is the role of phosphate buffer system?

Answer 14

plays a role in plasma and red blood cells and is involved in the exchange of sodium ion in the urine H+ filtrate

Question 15

main component of plasma protein

Answer 15

the imidazole groups of histidine

Question 16

Differentiate the two types of acidosis/alkalosis.

Answer 16

primary respiratory - disorder caused by ventilatory dysfunction
non-respiratory - caused by bicarbonate imbalance. (renal, metab func)

Question 17

Which is/are false?
A. If the imbalance is of nonrespiratory origin, the body compensates by altering ventilation
B. For disturbances of the respiratory component, the kidneys compensate by selectively excreting or reabsorbing anions and cations
C. Lungs - don’t compensate immediately, but response is often complete
D. Kidneys - faster to respond, but short term and incomplete

Answer 17

C and D

baliktad

Question 18

fully compensated - normal range ang pH

identify ratio for this

Answer 18

20 carbonic acid: 1 bicarbonate

Question 19

METABOLIC ACIDOSIS is a decrease in bicarbonate. The ff can make this happen, except:
A.the direct administration of an acid-producing substance, such as ammonium chloride and calcium chloride
B.by lack of formation of organic acids as seen with diabetic ketoacidosis and starvation
C.reduced excretion of acids, as in renal tubular acidosis
D.excessive loss of bicarbonate from diarrhea or drainage from a biliary, pancreatic, or intestinal fistula

Answer 19

B

excessive dapat

Question 20

Which is false?
A. symptoms of metabolic acidosis are hard to diagnose
B. If alkalosis comes with vomiting, H2SO4 is excreted.

Answer 20

T

Question 21

Identify

deep, rapid breathing; classically associated with diabetic ketoacidosis

Answer 21

Kussmaul respirations

Question 22

Main diagnostic procedure for metabolic acidosis

Answer 22

Arterial blood gas sampling

Question 23

Which may not lead to respiratory acidosis?
A.chronic hypercarbia in COPD patients
B.less lung surface for gas exchange
C.bronchopneumonia
D.alcohol
E.NOTA

Answer 23

E

Alcohol depresses respi func –> CO2 accum

Question 24

Differentiate acute respi acidosis fr chronic:

Answer 24

chronic does not have acidemia

acute does not have elevated serum bicarbonate

Question 25

``` Which factor may not cause metabolic alkalosis (gain in bicarbonate)? A.sodium citrate B.diuretics C.vomiting D.alcohol ```

Answer 25

D | Alcohol --> respi acidosis

Question 26

``` Which factor may not cause respi alkalosis (loss in CO2)? A.hypoxemia B.diuretics C.pulmonary emboli D.pulmonary fibrosis ```

Answer 26

B - for metabolic alkalosis

Question 27

___ receives electron pairs from the oxidation of NADH and FADH2 leading to the release of the energy used to synthesize ATP from the phosphorylation of ADP

Answer 27

Molecular oxygen

Question 28

Each adult hemoglobin molecule combine reversibly with | up to __ molecules of oxygen

Answer 28

4

Question 29

``` The actual amount of oxygen loaded onto hemoglobin depends on all except A.Concentration and types of hemoglobin B.pH C.Temperature of the blood D.2,3-monophosphoglycerate ```

Answer 29

D Diphosphoglycerate dapat

Question 30

Identify hemoglobin type hemoglobin not bound to oxygen but capable of forming a bond when oxygen is available

Answer 30

Deoxyhemoglobin

Question 31

``` Identify type of hemoglobin hemoglobin bound to CO (bond between CO and Hb is reversible but is 200 times as strong as the bond between O2 and Hb) ```

Answer 31

Carboxyhemoglobin

Question 32

``` Identify type of hemoglobin hemoglobin unable to bind oxygen because iron is in an oxidized rather than reduced state; Fe3 + can be reduced by methemoglobin reductase (red blood cells) ```

Answer 32

Methemoglobin

Question 33

``` 2,3-diphosphoglycerate - An organophosphate created in __ during glycolysis A. Leukocytes B. Erythrocytes C. Thrombocytes D. AOTA ```

Answer 33

B

Question 34

``` Does not cause increase in 2,3-DPG A.hypoxaemia B.anaemia C.septic shock D.congestive heart failure ```

Answer 34

C

Question 35

In oximeter, pO2 measurement is amperometric – what does this mean?

Answer 35

that the amount of | current flow is an indication of the oxygen present

Question 36

pCO2 and pH measurements are potentiometric - what does this mean

Answer 36

a | change in voltage indicates the activity of each analyte

Question 37

The actual percent __(O2 d etermined spectrophotometrically using a CO-oximeter designed to directly measure the various hemoglobin species. A.methemoglobin B.oxyhemoglobin C.myoglobin D.NOTA

Answer 37

b

Question 38

If the specimen is exposed to air, pH (increases, decreases)

Answer 38

Increases

Question 39

If the specimen is RT > 30 min, pH (increases, decreases)

Answer 39

Decreases

Question 40

If the specimen is RT > 30 min, pCO2 (increases, decreases)

Answer 40

Increases

Question 41

If the specimen is exposed to air, pO2(increases, decreases)

Answer 41

Increases