Test 3 Study Guide

Question 1

HCO3 is controlled by this organ

Answer 1

Kidneys

Question 2

PCO2 is controlled by this organ

Answer 2

Lungs

Question 3

Hyperventilation levels

Answer 3

PaCO2 < 35 mm Hg

Question 4

Hypoventilation levels

Answer 4

PaCO2 > 45 mm Hg

Question 5

Normal PaCO2 levels

Answer 5

35 to 45 mm Hg

Question 6

Hypercapnia is another term for….

Answer 6

Respiratory Acidosis

Question 7

Hypocapnia is another term for….

Answer 7

Respiratory Alkalosis

Question 8

Respiratory Acidosis PACO2 levels

Answer 8

> 45 mm Hg

Question 9

Respiratory Alkalosis PACO2 levels

Answer 9

< 35 mm Hg

Question 10

Normal pH levels

Answer 10

7.35 to 7.45

Question 11

Acidemia levels

Answer 11

< 7.35

Question 12

Alkalemia levels

Answer 12

> 7.45

Question 13

any substance that donates a proton [H+] to an aqueous solution (sour taste).

Answer 13

Acid

Question 14

A [H+] donor is an _____.

Answer 14

Acid

Question 15

any substance that accepts a proton [H+] , removing it from a solution (bitter taste).

Answer 15

Base

Question 16

A [H+] acceptor is a _____.

Answer 16

Base

Question 17

Theory stating that an acid donates protons and a base accepts protons.

Answer 17

Bronsted-Lowry theory

Question 18

The _____ ______ _____ consists of carbonic acid (H2CO3) and
its conjugate base, HCO3-.

Answer 18

Bicarbonate Buffer System

Question 19

The bicarbonate buffer system is also known as an _____ buffer system.

Answer 19

Open buffer system

Question 20

Two places where bicarbonate buffers

Answer 20

In the plasma and In the erythrocyte

Question 21

The body continually produces _____ ions as a product of ___ metabolism

Answer 21

hydrogen ions, aerobic metabolism

Question 22

H+ ions formed in the body arise from these three acids

Answer 22

Volatile acids (H2CO3)
carbonic acid (excreted in lungs)
Nonvolatile acids (excreted in kidneys)

Question 23

____ acids do not have a gaseous component.

Answer 23

Fixed

Question 24

The _____ buffer system consists mainly of phosphates and
proteins, including hemoglobin

Answer 24

Nonbicarbonate

Question 25

The nonbicarbonate system is also called the ______ buffer system.

Answer 25

Closed

Question 26

Most common component in the nonbicarbonate buffer system

Answer 26

Hemoglobin (most important)

Question 27

The _____ physically remove H+ from the body, and it is dependent on the blood level of hydrogen ions.

Answer 27

Kidneys

Question 28

Normal pH values

Answer 28

7.35 - 7.45

Question 29

Normal PaCO2 levels

Answer 29

35 - 45mm Hg

Question 30

Normal PaO2 levels

Answer 30

80 - 100 mm Hg

Question 31

Normal HCO3 levels

Answer 31

22 - 26 mEq/L

Question 32

Normal BE

Answer 32

± 2 mEq/L

Question 33

chronic disturbance (non-causative component changed such that pH is in normal range).

Answer 33

Compensated

Question 34

acute disturbance (non-causative component did not have enough time to change).

Answer 34

Uncompensated

Question 35

pH not yet in normal range; non- causative component changed in appropriate direction but has not had enough time to change sufficiently.

Answer 35

Partly compensated

Question 36

pH levels at full compensation

Answer 36

7.35 to 7.45

Question 37

Causes of respiratory acidosis

Answer 37

COPD = most common cause. * CNS depression. * Extreme obesity. * Neuromuscular disease

Question 38

Hypoventilation causes _____

Answer 38

hypercapnia (respiratory acidosis

Question 39

Acute hypoxia (due to an exacerbation) ____ alveolar ventilation via hypoxic drive

Answer 39

Increases

Question 40

Acute reduction in PaCO2 _____ pH

Answer 40

Increases

Question 41

Compensated respiratory acidosis should not be misinterpreted as ____ _____ _____.

Answer 41

Compensated metabolic alkalosis

Question 42

Causes of metabolic alkalosis

Answer 42

Vomiting Nasogastric drainage Diuretics NaHCO3 infusion or ingestion

Question 43

Levels of hypoxemia

Answer 43

Normal: 80-100 Mild hypoxemia: 60-79 Moderate hypoxemia: 40-59 Severe hypoxemia: < 40

Question 44

Signs and symptoms of hypoxia

Answer 44

50 to 60 mm Hg = mild nausea, lightheadedness, and dizziness and increase in minute ventilation. 35 to 50 mm Hg = mental confusion. * <35 mm Hg = decreased renal blood flow and cardiac conduction disturbances. * <25 mm Hg = loss of consciousness and respiratory center depression.

Question 45

(VA/QC = infinity). * Normal ventilation but no perfusion.

Answer 45

Absolute dead space

Question 46

(VA/QC < infinity but > 1) * Normal ventilation with decreased blood flow.

Answer 46

Relative dead space

Question 47

; (Right-to-left shunt);

Answer 47

Anatomical shunt

Question 48

Bronchial systemic veins (carrying deoxygenated blood) emptying directly into the pulmonary veins (carrying freshly oxygenated blood).

Answer 48

Normal anatomical shunt

Question 49

Ventricular septal defect: Septum separating the right and left ventricles has a large hole, allowing deoxygenated right ventricular blood to mix with oxygenated left ventricular blood.

Answer 49

Abnormal anatomical shunt

Question 50

* Best known index of oxygen-transfer efficiency. *  A-a gradient =  physiological shunting.

Answer 50

P(A-a)O2 : (A-a difference);

Question 51

Represents the percentage of alveolar PO2 transferred to the arterial blood. * More stable than A-a gradient when FIO2 changes. * Normal a-A ratio = 0.75 - 0.95 * Used to predict FIO2 required to achieve desired PaO

Answer 51

PaO2/PAO2 : (a-A ratio);

Question 52

Normal P(A-a)O values = 5 to 10 mm Hg

Answer 52

breathing room air

Question 53

An increase in P(A-a)O2 indicates impaired ___ transfer across the lung

Answer 53

O2

Question 54

P(A-a)O2 = 30 to 60 mm Hg

Answer 54

Breathing 100% O2

Question 55

Why is the P(A-a)O2 up when FIO2 is up?

Answer 55

Hb is saturated to capacity when PO2 is between 100 to 663 mm Hg.

Question 56

(VA/QC = 0) * Ventilation ceases but perfusion is normal.

Answer 56

Absolute shunt

Question 57

(VA/QC > 0 but < 1) * Ventilation is decreased but perfusion is normal.

Answer 57

Relative shunt

Question 58

However from base to apex, blood flow ____ at a more rapid rate than the decrease in ventilation.

Answer 58

Decreases

Question 59

____ regions are over-ventilated with respect to blood flow.

Answer 59

Apical

Question 60

___ regions are relatively under-ventilated with respect to blood flow.

Answer 60

Basal

Question 61

As a result, the VA/QC ratio progressively ____ from the lung base to the lung apex in the upright lung.

Answer 61

Increases

Question 62

VA/QC mismatch (VA/QC <1 but >0) is the most common cause of ___

Answer 62

Hypoxemia

Question 63

* VA /QC mismatch is also called a ____ ___

Answer 63

Relative shunt

Question 64

* VA /QC mismatch responds well to ____

Answer 64

O2

Question 65

Average resting alveolar ventilation (VA)

Answer 65

4 L/min

Question 66

Resting pulmonary capillary blood flow (QC)

Answer 66

5 L/min

Question 67

Normal ventilation/perfusion ratio (VA /QC) ratio

Answer 67

0.8 for the lung as a whole.

Question 68

What is the basic defect of a disease that causes intrapulmonary shunting?

Answer 68

Any condition that causes alveoli to become airless creates shunt.

Question 69

Examples of conditions that cause intrapulmonary shunting

Answer 69

alveolar collapse (atelectasis) and alveolar filling or consolidating processes (e.g., pneumonia).