Acid Base Balance

Question 1

Why is maintenance of pH important?

Answer 1

Protein structure

Metabolism and Enzymes

Question 2

What determines pH?

Answer 2

pCO2
Addition or removal of acids (H+)
Strong ion movements
Serum proteins, phosphates, and other weak acids

Question 3

What are the regulatory systems of blood pH?

Answer 3

Extracellular and intracellular buffers
Rate of alveolar ventilation
Renal excretion of H+

Question 4

What is the reason for buffer systems?

Answer 4

Minimize the changes in H+

Prevent sudden changes in pH

Question 5

What are the components of the buffer system?

Answer 5

Bicarbonate/carbonic acid

Non bicarbonate components: Hemoglobin, Plasma Proteins, others

Question 6

What are venous samples used for?

Answer 6

Good for evaluating acid base status

Question 7

What are arterial samples used for?

Answer 7

Evaluate pO2

Useful for evaluating cardiopulmonary function

Question 8

What tube is Blood gas analysis collected in?

Answer 8

Green Top Tube with Heparin

Question 9

TCO2

Answer 9

Bicarbonate

Question 10

pCO2

Answer 10

Acid

Question 11

pCO2

Answer 11

Respiratory

Question 12

HCO3

Answer 12

Metabolic

Question 13

Increase of pH

Answer 13

Alkalemia

Question 14

Decrease of pH

Answer 14

Acidemia

Question 15

What causes Respiratory Acidosis

Answer 15

Hypoventilation

Question 16

What causes Respiratory Alkalosis?

Answer 16

Hyperventilation

Question 17

What causes Metabolic Acidosis?

Answer 17

Increased acid in the absence of increased pCO2

Decreased HCO3

Question 18

What causes Metabolic Alkalosis?

Answer 18

Decreased acid in the absence of decreased pCO2

Increased HCO3

Question 19

Measurement of TCO2

Answer 19

Estimate of plasma bicarbonate concentration

Question 20

Base Excess

Answer 20

Characterizes the overall metabolic acid-base status independent of the respiratory acid-base status

Question 21

Metabolic alkalosis

Answer 21

+ Base Excess

Question 22

Metabolic Acidosis

Answer 22

• Base Excess

Question 23

What are the 4 primary acid base abnormalities?

Answer 23

Respiratory Acidosis
Metabolic Acidosis
Respiratory Alkalosis
Metabolic Alkalosis

Question 24

What is the body’s compensatory response to abnormal pH?

Answer 24

Opposite system, Opposite type

Question 25

What causes Hypoventilation

Answer 25

Anesthesia Diffuse pulmonary disease Intrathoracic lesions CNS disease

Question 26

What is the compensation for Respiratory Acidosis?

Answer 26

Secondary Metabolic Alkalosis = Retention of HCO3

Question 27

What are the 2 way Metabolic Acidosis can happen?

Answer 27

Increase in acid | Decrease in base

Question 28

What causes High Anion Gap Acidosis?

Answer 28

Ketones Lactate Uremic Acids Ethylene glycol

Question 29

What is the calculation for anion gap?

Answer 29

(Na + K) - (Cl+ HCO3)

Question 30

How is HCO3 lost?

Answer 30

``` Diarrhea Intestinal ileus Salivation Urinary loss Titration ```

Question 31

What is the short term compensation for Metabolic Acidosis?

Answer 31

Increased ventilation with decreased pCO2

Question 32

What is the long term compensation for Metabolic Acidosis?

Answer 32

Increased renal excretion of H+ with retention of HCO3

Question 33

What causes Hyperventilation?

Answer 33

Hypoxemia Pain, Anxiety Hyperthermia Drugs that stimulate the medullary respiratory center

Question 34

What is the compensation for Respiratory Alkalosis?

Answer 34

Secondary Metabolic acidosis = renal retention of H+

Question 35

What is the 2 way Metabolic Alkalosis can happen?

Answer 35

Decreased Acid | Increased Base

Question 36

What are the causes of Hypochloremic Metabolic Alkalosis?

Answer 36

Severe vomiting, pyloric obstruction | Sequestration of fluid in abomasum and forestomaches

Question 37

What causes Excessive Renal loss of H+?

Answer 37

Diuretics | Increased mineralcorticoid activity (aldosterone)

Question 38

What is the short term compensation for metabolic alkalosis?

Answer 38

Decreased ventilation and increased pCO2

Question 39

What is the long term compensation for metabolic alkalosis?

Answer 39

Increased renal retention of H+ with decreased generation of HCO3