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Biochemistry > Chapter 16 - Acid/Base Balance > Flashcards

Chapter 16 - Acid/Base Balance Flashcards

(62 cards)

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1
Q

pO2 reference interval (arterial blood)

A

80-100 mm Hg

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1
Q

pH reference interval (arterial blood)

A

7.35-7.45

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2
Q

pCO2 reference interval (arterial blood)

A

35-45 mm Hg

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3
Q

HCO3 Reference interval (arterial blood)

A

22-26 mEq/L

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4
Q

Base Excess reference interval (arterial blood)

A

-2 to 2 mEq/L

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5
Q

What are the measurements that are directly measured by an electrode in arterial blood?

A

pH
pO2
pCO2

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6
Q

What are the measurements that are calculated in arterial blood?

A

HCO3
Base Excess

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7
Q

What does a negative base excess imply?

A

Acidosis

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8
Q

What does a positive base excess imply?

A

Alkalosis

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9
Q

What is base excess?

A

The amount of excess or insufficient bicarbonate?

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10
Q

Pulse oximetry reference interval

A

95-100%

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11
Q

What does pulse oximetry measure?

A

Oxygen saturation of hemoglobin

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12
Q

Boyle’s Law

A

At a constant temperature, the volume of a gas varies inversely to the pressure exerted to contain it

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13
Q

Charles’s Law

A

At a constant pressure, the volume of a gas varies with temperature (increases as it increases)

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14
Q

Dalton’s Law

A

Total pressure of gas mixture is the sum of the partial pressures of each gas

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15
Q

Henry’s Law

A

The amount of a dissolved gas is proportional to the partial pressure of the gas over the liquid

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16
Q

Specimens have to be contained (capped) or gas will escape. Which Law does this correspond to and why?

A

Boyle’s Law
At a constant temp, inc Vol. = dec Pressure

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17
Q

Blood gas assays are temperature dependent. Which Law does this correspond to and why?

A

Charles’s Law
At a constant pressure, inc temp = inc volume

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18
Q

Blood has more than one gas in it, and we can measure pressures individually. Which Law does this correspond to and why?

A

Dalton’s Law
Total Pressure = Sum of partial pressures

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19
Q

Gas that diffuses from the blood sample is proportional to the blood concentration. Which Law does this correspond to and why?

A

Henry’s Law
Dissolved gas = partial pressure of gas above liquid

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20
Q

Where are gasses in the blood that we use to measure partial pressures?

A

Dissolved in plasma
and
Combined with hemoglobin

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21
Q

Describe the process of gas transfer of O2 and CO2 at the tissue

A

O2 RBC –> O2 Tissues
CO2 Tissues –> CO2 RBC
CO2 + H2O (Carbonic Anhydrase) —> H2CO3 (Carbonic Acid)
Carbonic Acid —> HCO3 + H+
Chloride Shift
Hemoglobin buffers Hydrogen ion

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22
Q

Describe the process of gas transfer of O2 and CO2 at the lung

A

O2 Lung –> O2 RBC
Reverse Chloride Shift
Hemoglobin releases H+
HCO3 + H+
Carbonic Acid/H2CO3 (Carbonic Anhydrase) –> CO2 + H2O
CO2 RBC –> CO2 Lung

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23
Q

At pO2 of 30, what percent of hemoglobin is saturated?

A

50%

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24
At pO2 of 50, what percent of hemoglobin is saturated?
80%
25
At pO2 of 60, what percent of hemoglobin is saturated?
90%
26
At pO2 of 80, what percent of hemoglobin is saturated?
100%
27
Hemoglobin behavior is influenced by what factors
pH pCO2 Temperature 2,3 DPG levels
28
What happens to hemoglobin saturation at pO2 of 30, if in left shift?
Instead of 50% Hgb saturation, it's increased at 70%.
29
How should you mix an ABG tube?
Roll on 3 axes for 2 minutes Undermining = clots
29
Collection protocol for measurement of arterial blood gases
Dry heparin Short bevel No tournique No air/bubbles
30
What makes effects of air/bubbles worse
Big difference between ambient air and patient pO2 Lower temperature Agitated sample Bubbles big or exposed to blood too long
31
Glass syringes for ABG should be analyzed when
No more than 1 hour on ice
32
Plastic syringes for ABG should be analyzed when
Within 30 minutes at room temperature
33
Why should plastic syringes not be put on ice
Cold makes the syringes more permeable to oxygen and increases hemolysis
34
PO2 electrode
Oxygen passes through gas permeable membrane Reacts with polarized platinum electrode Reduced and generates a current Current = oxygen concentration
35
pCO2 electrode
CO2 passes gas permeable membrane Enters sodium bicarbonate buffer soon Reacts with buffer producing carbonic acid, changing pH pH change sensed by internal pH electrode pH decreases in proportion to CO2 present
36
pH electrode
H+ migrates into outer layer of glass, replacing sodium ions Chrloide ions are drawn into the inner membrane surface Silver ions are released by the internal silver/silver chloride element Voltage changes in proportion to the H+ concentration
37
Henderson-Hasselback equation
Formula to determine bicarb pH = 6.1 + log ( HCO3/ 0.0306 * pCO2)
38
Alternate ABG specimens
Venous Arterialized capillary blood
39
How are arterialized capillary blood samples prepared
Finger warmed for 10 minutes Systolic bp must be at least 95 mm Hg
40
How does a delay in analysis affect ABG specimens
Oxygen consumed Acidic pH, Glycolysis produces CO2
41
Effects of metabolism worse when what cells are high?
Retics Platelets WBC
42
Species with high WBC and PLT need to be analyzed within how long?
5 minutes
43
When should specimen be analyzed at RT? Why?
Within 30 minutes Bcz metabolism at RT causes non significant effect within first hour
44
How do bubbles in specimen affect ABG samples
pO2 false increase pCO2 false decrease pO2 false decrease if PT on oxygen therapy (PO2 > 150)
45
How do poorly sealed specimens affect ABG levels
Gases escape causing lower pO2 and pCO2 pH false increase
46
What temp are ABG specimens tested at?
37C
47
Pulse oximetry method
Red and Infrared lights shine into photo detector, difference between pulses = oxygenated vs deoxygenated blood
48
How much more tightly does CO bind hemoglobin than O2?
250 times more likely
49
Can carboxyhemoglobin bind oxygen?
NO
50
S/S of carbon monoxide poisoning
headache dizziness weakness nausea vomiting chest pain altered mental status death
51
Diagnostic measurement of carboxyhemoglobin in nonsmokers vs smokers?
2% carboxyhemoglobin non 9% carboxyhemoglobin smokers
52
CO treatment?
100% oxygen inhalation for 4-5 hours
53
Reference Method for CO measurement
Gas chromatography
54
Gas chromatography advantages
More sensitive than spectrophotometry More expensive, but not as fast
55
Best method for measuring CO levels >2-3%
Spectrophotometry
56
A pH of 6 is how much more acidic than 7?
10x
57
A pH of 5 is how much more acidic than 7?
100x
58
Each unit of pH change represents how much of a change in acidity or alkalinity?
10 fold
59
Calculated pH
-log (H+)
60

Biochemistry (26 decks)

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