Clinical Chem Test 2

Front 1

What are 4 metabolic reactions that create acids?

Back 1

1. Carbohydrate - lactic/pyruv.
2. Lipid - try - fa - ketone bod
3. Protein - AA - CO2
4. Nucleic acids - phosphoric

Front 2

What are 3 types of acids in the body?

Back 2

1. Fixed HPO4, HSO4
2. Organic - lactic acid, etc.
3. Volatile (CO2)

Front 3

What enzyme catalyzes the carbonic acid - bicarbonate buffer system?

Back 3

Carbonic anhydrase

Front 4

What are 4 physiologic buffer systems?

Back 4

1. Bicarbonate
2. Hemoglobin
3. Phosphate
4. Proteins

Front 5

What is the normal base:acid ratio for body buffering?
What maintains it?

Back 5

20:1
Maintained by lungs

Front 6

How set up henderson-hassel eqn for acid/base physiology?

Back 6

ph=6.1 + log(kidney/lung)

Front 7

What residue in Hb allows buffering?

Back 7

imidizole - 16/molecule
pKa = 7.3

Front 8

How is inhaled CO2 transported
-in plasma
-in RBCs

Back 8

plasma = HCO3-
RBCS = H+ w/ Hb -> HbH

Front 9

In Lungs, how is Hgb a stronger acid, bound to O2 or unbound?

Back 9

Oxygenated - bound.

Front 10

Where is the phosphate buffering system important?

Back 10

In urine

Front 11

What does blood gas msmt tell us?

Back 11

how well the cardiopulmonary homeostasis is maintained.

Front 12

What are arterial blood gases used to assess?

Back 12

1. Adequecy of oxygenation
2. Adequecy of ventilation
3. Acid-base balance status.

Front 13

What are these laws:
-Boyle's
-Charles'
-Guy-Lussac's

Back 13

Boyle: P1V1 = P2v2
Charl: V/T = V/T
Guy: P/T = P/T

Front 14

What are these laws:
Dalton's
Henry's
Fick's

Back 14

D: Total P = sum of partials
F: solubility = Pressure/Temp
H: gas diffusion

Front 15

What is arterial oxygenation?

Back 15

the oxygen in arterial blood

Front 16

what does arterial oxygenation depend on?

Back 16

1. Fraction of inspired O2
2. Ventilation of alveoli
3. Diffusion across alveolar/capillary membrane.
4. O2-carrying capacity of blood.

Front 17

In what 2 forms does O2 transport in blood?

Back 17

Dissolved in plasma = 3%
Bound to Hb = 97%

Front 18

What is dissolved o2 important for?

Back 18

cellular oxidative processes

Front 19

Which fraction of O2 changes the oxyhb dissociation curve?

Back 19

dissolved

Front 20

How do increases affect the O2-Hgb dissociation curve?
pH, CO2, Temp, CO, 23DPG, HbS, HbF, Young/old hb?

Back 20

pH incr, left
CO2 incr, right
Temp, right
CO, left
23DPG, right
HbS/young, right
HbF/old, left

Front 21

What does the blood oxygen content represent?

Back 21

Actual amount of O2 in blood, dissolved + bound to Hb.

Front 22

What is the p50 in a right/left shift?

Back 22

Right shift: >27 torr
Left shift: < 27 torr

Front 23

What measurement tells if the tissue O2demand is being met?

Back 23

O2 Content - NOT pO2

Front 24

What is Hypoxemia?
Hypoxia?

Back 24

Decr. O2 content of blood.
Decr. O2 supply to tissue.

Front 25

How does hypoxia affect body pH?

Back 25

Causes acid to increase because of switch to anaerobic cellular metabolism.

Front 26

What are 4 classes of Hypoxia?

Back 26

1. Arterial (low arterial O2)
2. Anemic (low O2 carry capac.)
3. Circulatory (bad circulation)
4. Histotoxic (bad utilization)

Front 27

What is the most physiologically reflective blood gas measurement of oxygenation?

Back 27

pCO2

Front 28

What determines the pCO2?

Back 28

Metabolism

Front 29

in what 3 basic forms is CO2 carried in blood?

Back 29

1. Dissolved in plasma
2. Carbamino compounds
3. Bicarbonate ions

Front 30

What happens to dissolved CO2 in plasma?

Back 30

It combines with water to form carbonic acid then H+/HCO3-

Front 31

What's normal ratio CO2:H2CO3?

Back 31

1000:1

Front 32

How does CO2 form carbamino compounds?

Back 32

By complexing with N-terminal side groups of amino acids.

Front 33

What diffuses in exchange for HCO3- from RBCs?

Back 33

Chloride ions

Front 34

What is the physiological pH reference range?

Back 34

7.35-7.45

Front 35

What are 5 examples of things that can cause a respiratory acidosis?

Back 35

1. Bad respiratory center
2. Defective nerves/muscles
3. thoracic cage disorder
4. airway obstruction
5. pulmonary disease

Front 36

At an initial respiratory acidosis, what is HCO3-?

Back 36

In reference range. Then it increases, compensate for acid.
If no compens, it decreases.

Front 37

What are 4 effects a decreased pH has on metabolism?

Back 37

1. Altered proteins
2. Right shift for Hemoglobin
3. lung blood vessels constrict
4. Heart contractility decrease

Front 38

what are 5 things that can cause a respiratory alkalosis?

Back 38

1. response to hypoxis
2. drugs and toxins
3. CNS disorders
4. Psychogenic hyperventilation
5. reflex stim of respiration

Front 39

What is the compensation mechanism for resp acidosis?

Back 39

Increase renal excretion of acid, reabsorption of bicarb. Takes several days, no full comp

Front 40

What is the compensation mechanism for resp alkalosis?

Back 40

Decr. H+ excretion, bicarb reabsorption.

Front 41

What causes metabolic alkalosis?

Back 41

vomiting
eating bicarb (antacids)
depleted potassium
diuretics

Front 42

-What is the anion gap, and how do you calculate it?
-What should it be?

Back 42

Difference btwn unmeasured anions/cations: (Na+K)-(CL+HCO3)
Should be 17 or lower.

Front 43

What does the BE tell us?

Back 43

Base excess - positive indicates excess, negative indicates deficit.