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23 Cards in this Set
- Front
- Back
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What system represents the first line of defense in maintaining pHa homeostasis?
a. Ventilatory respone b. Buffer systems c. Renal response |
1.) B
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2.) In what order of importance are the buffer systems in the blood?
a. Bicarb buffer system, hemoglobin buffer system, other protein buffer systems, phosphate buffer system b. Hemoglobin buffer system, Bicarb buffer system, phosphate buffer system, other protein buffer systems c. Phosphate buffer system, Hemoglobin buffer system, Bicarb buffer system, other protein buffer systems |
2.) A
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3.) True or False
a. Your pH will decrease 0.08 unit for every acute 10mmHg increase in PaCo2. |
3.) True
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4.) What does the anion gap help you determine?
a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis |
4.) A
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5.) True or False
a. A person with a high serum albumin concentration is anticipated to have a lower anion gap. |
5.) False
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6.) Arterial hypoxemia (Pao2 <60mmHg) may be caused by
a. Low Po2 in inhaled gases b. Hypoventilation c. Venous admixture with or without decreased mixed venous O2 content d. All of the above |
6.) D
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7.) Normal oxyhemoglobin dissociation curve is characterized by 50% saturation of hemoglobin with oxygen at a Pao2 of ?
a. 20 b. 26 c. 30 d. 25 |
7.) B
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8.) Things that shift the oxyhemoglobin dissociation curve to the left include:
a. Alkalosis b. Hyperthermia c. Decreased 2,3 DPG d. All of the above e. A and C only |
8.) E
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9.) Things that shift the oxyhemoglobin curve to the right include:
a. Acidosis b. Hyperthermia c. Increased 2,3 DPG d. All of the above |
9.) D
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Acidemia refers simply to a
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pHa less than 7.35
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alkalemia refers simply to a
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to a blood pHa greater than 7.45, regardless of the mechanism.
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Base excess, a number frequently provided on arterial blood gas studies, refers to
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the nonrespiratory or metabolic component of an acid-base disturbance.
base excess is the amount of strong acid (hydrochloric acid for base excess greater than zero) or strong base (sodium hydroxide for base excess less than zero) titrated to normalize the pHa of a blood sample under standardized conditions (37°C and Paco2 of 40 mm Hg). |
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Three basic systems are in place to prevent changes in pHa:
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(1) buffer systems, (2) the ventilatory response, and (3) the renal response.
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respond in minutes to changes in carbon dioxide or pHa by increasing or decreasing alveolar ventilation to change Pacoz in blood, which in turn changes pHa.
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Chemoreceptors in the carotid bodies and to a lesser extent the aortic arch and in the ventral surface of the medulla
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Renal Response
REGULATION OF THE HYDROGEN ION |
The proximal tubules of the kidney regulate plasma bicarbonate levels by nearly complete reabsorption of ?icarbonate from the glomerular filtrate and by secretion of · hydrogen ions into the tubular lumen with concomitant intracellular bicarbonate production.
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When the pHa is lower than _______ , however, myocardial responsiveness to catecholamines decreases and the compensatory increases in myocardial contractility are diminished
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7.1
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Respiratory acidosis with a pHa below ______ indicates the need for tracheal intubation and increased ventilatory support.
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7.1
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The anion gap is the measured concentration difference
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between sodium cations and the sum of chloride and bicarbonate anions and represents the concentration of anions (known and unknown) in serum that are unaccounted for in this equation.
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A normal anion gap value is
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3 to 11 mEqlL
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A patient with a low serum albumin concentration is anticipated to have a _______ anion gap value.
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lower
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Overzealous fluid resuscitation with 0.9% normal saline will induce
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an iatrogenic normal-gap metabolic acidosis secondary to excessive chloride administration, which impairs bicarbonate reabsorption in the kidneys
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Arterial hypoxemia, as reflected by a decrease in Pa02 to less than 60 mm Hg, may be caused by 3X
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(l) a low P02 in ( the inhaled gases (altitude, accidental occurrence during anesthesia), (2) hypoventilation, and (3) venous admixture with or without decreased mixed venous oxygen content
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Venous admixture refers to
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deoxygenated venous blood mixing with oxygenated arterial blood through shunting. Shunting is blood circulating from the right side of the heart to the left side via the lungs (intrapulmonary) or other routes (ventricular septal defect in the heart) without becoming oxygenated.
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