Acid-Base D/O

Question 1

What is the normal pH range of human blood?

Answer 1

7.35 to 7.45

Question 2

True or False: Acidosis refers to a condition where blood pH is below 7.35.

Answer 2

True

Question 3

What is the primary organ responsible for acid-base regulation?

Answer 3

Kidneys

Question 4

1) normal h+ ion concentration in nmol/L & pH?
2) acidemia
3) alkalemia

Answer 4

1) 40 nmol/L (7.4 pH)
2) increased h+ ions, <7.35 pH
3) decreased h+ ions, >7.45 pH

Question 5

What is the primary extracellular buffer system in the blood?

Answer 5

Bicarbonate buffer system

Question 6

True or False: The lungs can regulate blood pH by changing the rate of carbon dioxide exhalation.

Answer 6

True

Question 7

What is metabolic acidosis?

Answer 7

A condition characterized by a decrease in blood pH due to increased acid or loss of bicarbonate.

Question 8

Multiple Choice: Which of the following conditions can lead to respiratory acidosis? (A) Hyperventilation (B) COPD (C) Metabolic alkalosis

Answer 8

B) COPD

Question 9

What is the role of the kidneys in acid-base balance?

Answer 9

The kidneys excrete hydrogen ions and reabsorb bicarbonate.

Question 10

Fill in the blank: An increase in carbon dioxide levels in the blood causes a __________ in pH.

Answer 10

decrease

Question 11

True or False: Respiratory alkalosis occurs when there is an excess of carbon dioxide in the blood.

Answer 11

False

Question 12

What is the compensatory mechanism for metabolic acidosis?

Answer 12

Increased respiratory rate to exhale more CO2.

Question 13

Multiple Choice: Which of the following is NOT a cause of metabolic alkalosis?
(A) Vomiting (B) Diarrhea (C) Diuretics

Answer 13

B) Diarrhea

Question 14

What is the effect of hyperventilation on blood pH?

Answer 14

It increases pH, leading to respiratory alkalosis.

Question 15

Fill in the blank: A high anion gap indicates __________ acidosis.

Answer 15

metabolic

Question 16

True or False: The body can tolerate a wide range of pH levels without severe consequences.

Answer 16

False

Question 17

What is the primary effect of acidosis on the body’s functions?

Answer 17

It can impair enzyme activity and disrupt cellular functions.

Question 18

Multiple Choice: Which of the following is a clinical manifestation of acidosis? (A) Confusion (B) Hyperactivity (C) Hypertension

Answer 18

A) Confusion

Question 19

What does the term ‘compensation’ refer to in acid-base regulation?

Answer 19

The body’s physiological response to restore normal pH.

Question 20

Fill in the blank: The __________ is the primary organ for excreting hydrogen ions.

Answer 20

kidney

Question 21

What is the difference between metabolic acidosis and respiratory acidosis?

Answer 21

Metabolic acidosis is due to excess acid or loss of bicarbonate, while respiratory acidosis is due to CO2 retention.

Question 22

True or False: Bicarbonate can be administered to treat acidosis.

Answer 22

True

Question 23

What laboratory test is commonly used to assess acid-base status? Where do you typically obtain the sample from?

Answer 23

Arterial blood gas (ABG) analysis (assesses gas exchange (ventilation) and acid-base disturbances)
- radial artery

Question 24

Standard result reference ranges:
1) pH
2) pCO2
3) HCO3
4) Na+

Answer 24

1) 7.35-7.45 pH
2) 35-45 pCO2
3) 22-26 mEq/L HCO3
3) 135-145 mEq/L

Question 25

Venous Blood Gas (VBG) measures what gases? what can it NOT accurately measure?

Answer 25

similar to ABG (pH, pCO2, HCO3) - it cannot accurately measure OXYGENATION

Question 26

What is the Henderson Hasselbach equation?

Answer 26

pH = 6.1 log (HCO3/(0.03 X pCO2))

Question 27

Is CO2 Acidic or basic? As respiration is increased, what happens to CO2?

Answer 27

Acidic it decreases (blown off)

Question 28

1) Conditions resulting in Alkalotic blood? 2) Condition resulting in Acidosis blood?

Answer 28

1) Hypocapnia, Hypocarbia, Alkalosis 2) Hypercapnia, Hypercarbia, Acidosis

Question 29

What gas is the RESPIRATORY component of acid-base determination? What gas is the METABOLIC (renal) component of acid-base determination?

Answer 29

1. CO2 (respiratory) 2. HCO3- (metabolic - renal)

Question 30

Bicarb < 22 is called? Bicarb >26 is called? Is bicarb an acid or base?

Answer 30

1. Acidosis 2. Alkalosis 3. Base

Question 31

How is base excess/deficit calculated? Base Excess = ? An Excess is a primary or prolonged compensation for what? Base Deficit = ?

Answer 31

1) using pH, pCO2, and hematocrit 2) Metabolic alkalosis 3) compensation for Respiratory acidosis 4) Metabolic acidosis

Question 32

What does the pO2 represent? What does the O2 saturation measure? What is the O2 content?

Answer 32

1) the force needed for O2 to diffuse across alveolar membrane 2) % of hemoglobin saturated with O2 3) total amount of O2 in the blood

Question 33

What 3 things can cause a decrease in pO2 and O2 content?

Answer 33

a) difficulty diffusing across the membrane in the lung as with pneumonia b) premature mixing of venous and arterial blood as in congenital heart disease c) underventilation or under perfused alveoli in the lungs as in significant atelectasis, obesity-hypoventilation syndrome

Question 34

What does the Alveolar (A) to arterial (a) gradient reflect? A HIGH A-a gradient can tell what 2 things?

Answer 34

1) the difference between alveolar and arterial O2 2a) problem diffusing O2 across alveolar membrane in lungs (ex. thickened edematous alveoli) 2b) unoxygenated blood prematurely mixing with oxygenated blood

Question 35

Define the anion gap (AG)? Equation? What is the normal AG range? what is high?

Answer 35

1) difference between measured cations and measured anions in the extracellular space (UNMEASURED anions) 2) Na - (Cl+HCO3) 3) 6-12 mEq/L; >12 is high

Question 36

How is the anion gap increased and decreased?

Answer 36

INCREASED with the accumulation of acidic anions (Lactate, acetoacetate) DECREASED with BICARB as it neutralizes acidic metabolic byproducts as they accumulate in the blood

Question 37

What are Anionic plasma proteins that are not measured?

Answer 37

Albumin, phosphates, sulfates, organic anions

Question 38

An AG >12 = ? an AG 12 and less = ? A higher AG is mostly related to what?

Answer 38

1) HIGH anion gap Metabolic acidosis 2) NORMAL anion gap metabolic acidosis 3) organic blood acids that the body is producing too much of

Question 39

What unmeasured anion is primarily responsible for the AG? Review equation slide17

Answer 39

albumin

Question 40

What are the 4 primary Acid-base disorders?

Answer 40

Respiratory - Acidosis (acute <3 d and chronic 3+ d) - Alkalosis (acute and chronic) Metabolic -Acidosis (NAGMA, HAGMA) -Alkalosis

Question 41

How do acid base disorders compensate? Which is faster?

Answer 41

respiratory (through pCO2) will compensate metabolic (via kidneys HCO3) and vice versa - Respiratory is faster

Question 42

Practice charts slide 20 and 21

Question 43

When should MIXED acid-base disorders be suspected?

Answer 43

1) inadequate or exaggerated compensatory response 2) changes in pCO2 and HCO3 are in OPPOSITE directions 3) no change in pH yet significant change in pCO2 and HCO3 4) Metabolic acidosis with certain (delta) AG/HCO3 ratios