Bryan - La Medicine - Fall Yr 3 - Blood Gas, Fluids

Front 1

T or F:
PCO2 can ONLY be interpreted on an arterial sample.

Back 1

False! This describes PO2.

Front 2

What are normal values for the following (in arterial blood):
pH
Bicarb
PCO2
anion gap

Back 2

pH 7.4
Bicarb 24
PCO2 40
AG 15-25 in SA; 10-20 in LA

Front 3

A drop in pH, bicarb, and PCO2 indicates...

Back 3

...metabolic acidosis

Front 4

An increase in pH, PCO2, and bicarb indicates...

Back 4

...metabolic alkalosis (usually iatrogenic).

Front 5

An increase in pH with a drop in PCO2 and bicarb indicates...

Back 5

...respiratory alkalosis.

Front 6

A decrease in pH with an increase in PCO2 and bicarb indicates...

Back 6

...respiratory acidosis.

Front 7

Predict the following relative values in a case of metabolic acidosis:
Base excess
PCO2
Anion Gap
HCO3

Back 7

Base excess WAY negative
PCO2 increased
anion gap increased
HCO3 decreased

Front 8

Fill in the blank, beeyatch!
Venous blood assesses the _________level while arterial blood assesses the _________ level.

Back 8

Venous = tissue level
Arterial = pulmonary level

Front 9

What are the major buffer systems in the body?

Back 9

BIcarbonate
Phosphate
Hemoglobin
Protein (albumin)
Bone
Lactate

Front 10

To calculate compensation, PaCO2 should change by a factor of ______ for every 1meq change in HCO3.

Back 10

1.2mm Hg change for every 1meq change of HCO3

Front 11

What are the 2 forms of lactate and what is the source of each?

Back 11

L-form (mammalian)
D-form (bacteria)

Front 12

What metabolite is associated with poor perfusion?

Back 12

Lactate

Front 13

How fast should lactate be cleared from the body?

Back 13

50% clearance within 24hrs

Front 14

How is lactate protective?

Back 14

Extruded from cell (removes acid)
Uses up H+ during lactate production
Can re-enter oxidative phosphorylation

Front 15

Choose type A or type B lactate production...
...ischemic event.

Back 15

Type A

Front 16

Choose type A or type B lactate production...
...anemia.

Back 16

Type A

Front 17

Choose type A or type B lactate production...
...toxin ingestion.

Back 17

Type B

Front 18

Choose type A or type B lactate production...
...neoplasia.

Back 18

Type B

Front 19

Choose type A or type B lactate production...
...maldistributive shock.

Back 19

Type A

Front 20

Choose type A or type B lactate production...
...sepsis.

Back 20

Type B

Front 21

What are the extracellular fluid compartments?

Back 21

Intravascular
Extravascular

Front 22

Estimate the following as % body weight for a healthy adult horse:
Body water
Extracellular fluid
Intravascular fluid

Back 22

Body water - 60-65%
Extracellular fluid - 30%
Intravascular fluid - 6%

Front 23

Estimate the following as % body weight for a calf:
Body water
Extracellular fluid
Intravascular fluid

Back 23

Body water - 85%
Extracellular fluid - 50%
Intravascular fluid - 8%

Front 24

Describe the following in a cow that is 8% dehydrated:
Mucous membranes
Skin tent
Eyes

Back 24

MM - tacky
Skin tent - 3-5sec
Eyes - normal

Front 25

Describe the following in a cow that is 12% dehydrated:
Mucous membranes
Skin tent
Eyes

Back 25

MM - dry, pale, cold
Skin tent - INFINITY
Eyes - sunken

Front 26

T or F:
A blood volume can be given as a shock dose.

Back 26

True!
6% bw for LA; 8% for SA

Front 27

What are the isotonic fluids?

Back 27

Buffered, pH balanced fluids (LRS, normasol, multisol)
Saline (0.98% NaCl)
5% dextrose

Front 28

What buffer is used in normasol?

Back 28

acetate

Front 29

When should fluid bicarb be given in a case of metabolic acidosis?

Back 29

When pH is <7.25

Front 30

How much bicarb should be given to a 400kg cow with a -12mEq/L base excess?

Back 30

0.3(400)x12 = 1440mEq bicarb

(remember, ECF is 30% of BW)

Front 31

How much bicarb should be given to a 200kg pony with a bicarb of 10mEq/L?

Back 31

0.3(200)*(24-10) = 840mEq

(normal bicarb is 24)

Front 32

How can metabolic alkalosis be treated with fluids?

Back 32

Give saline!
(no K or Ca)

Front 33

How can hypernatremia be treated with fluids?

Back 33

ORAL FLUIDS

Front 34

What are causes for hyperkalemia in large animals?

Back 34

Ruptured foal bladder
HYPP
Necrosis/Apoptosis

Front 35

How many g of Ca should be given to a 450kg cow with a serum Ca of 4 mg/dL (target is 10 mg/dL Ca)?

Back 35

0.3(450)*((10-4)*10)= 8.1g

Front 36

T or F:
Hetastarch will not affect the CBC but will affect TP.

Back 36

True!
Hetastarch doesn't show up in biochem but affects refractometry.

Front 37

If a 550kg horse has a PCV of 33%, what is the plasma volume?

Back 37

(0.06(550))*(1-0.33) = 22L

Front 38

If a 500kg horse has a PCV of 30%, a TP of 3, and you want to get TP up to 5, how many g of protein must be added? How many L of fluids from a donor with 6g/L protein must be added?

Back 38

(0.06)*(500)*(1-0.3)) = 21L plasma
21(5-3) = 42g protein needed!!
42/6 = 7 L of donor plasma

Front 39

At what PCV value should a transfusion be considered?

Back 39

12%

Front 40

Which is the best candidate for a blood donor?
a) brood mare
b) Qa positive stallion
c) Aa positive foal
d) Aa negative gelding

Back 40

d) Aa negative gelding

Front 41

What is the normal daily fluid intake for a...
...horse?
...cow?
...neonate?

Back 41

horse = 4-6% bw
cow = 7-10% bw
neonate = 10% bw

Front 42

How do ruminants use salivation as an excretory mechanism?

Back 42

Remove P, Urea, and excess heat

Front 43

Which of the following glands produce saliva similar in composition to plasma?
a) horse parotid gland
b) ruminant parotid gland
c) horse mandibular gland
d) camelid mandibular gland

Back 43

a) horse parotid gland

Front 44

Which of the following are true statements?
a) the parotid salivary secretions of ruminants are alkaline
b) the parotid salivary secretions of horses is plasma-like
c) the mandibular and parotid glands produce aqueous secretions
d) ruminant sublingual glands produce up to 2ml/kg/hr!!!

Back 44

a) the parotid salivary secretions of ruminants are alkaline
b) the parotid salivary secretions of horses is plasma-like

Front 45

What is the total salivary production of a resting ruminant? Eating?

Back 45

6ml/kg/hr at rest
9ml/kg/hr eating

Front 46

Choose ptyalism or pseudoptyalism...
...rabies infection.

Back 46

Ptyalism first, pseudoptyalism later.

Front 47

Choose ptyalism or pseudoptyalism...
...associated with canthardin.

Back 47

Ptyalism (blister beetles)

Front 48

Choose ptyalism or pseudoptyalism...
...associated with slaframine.

Back 48

Ptyalism

Front 49

Choose ptyalism or pseudoptyalism...
...associated with choke.

Back 49

Pseudoptyalism

Front 50

Choose ptyalism or pseudoptyalism...
...associated with palatoschisis.

Back 50

Pseudoptyalism

Front 51

Which of the following can cause a decrease in salivary production?
a) Sialolith
b) Parotid duct trauma
c) Neoplasia
d) Shock

Back 51

a) Sialolith
b) Parotid duct trauma (leads to sialocoele)
c) Neoplasia (parotid melanomas in grey horses)
d) Shock

Front 52

How does the parasympathetic system affect salivation? The sympathetic system?

Back 52

Para - Increases volume and aqueous secretion
Sym - No volume change; increases protein and mucin content