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43 Cards in this Set
- Front
- Back
What are 4 metabolic reactions that create acids?
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1. Carbohydrate - lactic/pyruv.
2. Lipid - try - fa - ketone bod 3. Protein - AA - CO2 4. Nucleic acids - phosphoric |
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What are 3 types of acids in the body?
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1. Fixed HPO4, HSO4
2. Organic - lactic acid, etc. 3. Volatile (CO2) |
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What enzyme catalyzes the carbonic acid - bicarbonate buffer system?
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Carbonic anhydrase
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What are 4 physiologic buffer systems?
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1. Bicarbonate
2. Hemoglobin 3. Phosphate 4. Proteins |
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What is the normal base:acid ratio for body buffering?
What maintains it? |
20:1
Maintained by lungs |
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How set up henderson-hassel eqn for acid/base physiology?
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ph=6.1 + log(kidney/lung)
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What residue in Hb allows buffering?
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imidizole - 16/molecule
pKa = 7.3 |
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How is inhaled CO2 transported
-in plasma -in RBCs |
plasma = HCO3-
RBCS = H+ w/ Hb -> HbH |
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In Lungs, how is Hgb a stronger acid, bound to O2 or unbound?
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Oxygenated - bound.
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Where is the phosphate buffering system important?
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In urine
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What does blood gas msmt tell us?
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how well the cardiopulmonary homeostasis is maintained.
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What are arterial blood gases used to assess?
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1. Adequecy of oxygenation
2. Adequecy of ventilation 3. Acid-base balance status. |
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What are these laws:
-Boyle's -Charles' -Guy-Lussac's |
Boyle: P1V1 = P2v2
Charl: V/T = V/T Guy: P/T = P/T |
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What are these laws:
Dalton's Henry's Fick's |
D: Total P = sum of partials
F: solubility = Pressure/Temp H: gas diffusion |
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What is arterial oxygenation?
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the oxygen in arterial blood
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what does arterial oxygenation depend on?
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1. Fraction of inspired O2
2. Ventilation of alveoli 3. Diffusion across alveolar/capillary membrane. 4. O2-carrying capacity of blood. |
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In what 2 forms does O2 transport in blood?
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Dissolved in plasma = 3%
Bound to Hb = 97% |
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What is dissolved o2 important for?
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cellular oxidative processes
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Which fraction of O2 changes the oxyhb dissociation curve?
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dissolved
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How do increases affect the O2-Hgb dissociation curve?
pH, CO2, Temp, CO, 23DPG, HbS, HbF, Young/old hb? |
pH incr, left
CO2 incr, right Temp, right CO, left 23DPG, right HbS/young, right HbF/old, left |
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What does the blood oxygen content represent?
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Actual amount of O2 in blood, dissolved + bound to Hb.
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What is the p50 in a right/left shift?
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Right shift: >27 torr
Left shift: < 27 torr |
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What measurement tells if the tissue O2demand is being met?
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O2 Content - NOT pO2
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What is Hypoxemia?
Hypoxia? |
Decr. O2 content of blood.
Decr. O2 supply to tissue. |
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How does hypoxia affect body pH?
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Causes acid to increase because of switch to anaerobic cellular metabolism.
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What are 4 classes of Hypoxia?
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1. Arterial (low arterial O2)
2. Anemic (low O2 carry capac.) 3. Circulatory (bad circulation) 4. Histotoxic (bad utilization) |
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What is the most physiologically reflective blood gas measurement of oxygenation?
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pCO2
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What determines the pCO2?
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Metabolism
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in what 3 basic forms is CO2 carried in blood?
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1. Dissolved in plasma
2. Carbamino compounds 3. Bicarbonate ions |
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What happens to dissolved CO2 in plasma?
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It combines with water to form carbonic acid then H+/HCO3-
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What's normal ratio CO2:H2CO3?
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1000:1
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How does CO2 form carbamino compounds?
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By complexing with N-terminal side groups of amino acids.
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What diffuses in exchange for HCO3- from RBCs?
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Chloride ions
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What is the physiological pH reference range?
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7.35-7.45
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What are 5 examples of things that can cause a respiratory acidosis?
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1. Bad respiratory center
2. Defective nerves/muscles 3. thoracic cage disorder 4. airway obstruction 5. pulmonary disease |
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At an initial respiratory acidosis, what is HCO3-?
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In reference range. Then it increases, compensate for acid.
If no compens, it decreases. |
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What are 4 effects a decreased pH has on metabolism?
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1. Altered proteins
2. Right shift for Hemoglobin 3. lung blood vessels constrict 4. Heart contractility decrease |
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what are 5 things that can cause a respiratory alkalosis?
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1. response to hypoxis
2. drugs and toxins 3. CNS disorders 4. Psychogenic hyperventilation 5. reflex stim of respiration |
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What is the compensation mechanism for resp acidosis?
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Increase renal excretion of acid, reabsorption of bicarb. Takes several days, no full comp
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What is the compensation mechanism for resp alkalosis?
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Decr. H+ excretion, bicarb reabsorption.
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What causes metabolic alkalosis?
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vomiting
eating bicarb (antacids) depleted potassium diuretics |
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-What is the anion gap, and how do you calculate it?
-What should it be? |
Difference btwn unmeasured anions/cations: (Na+K)-(CL+HCO3)
Should be 17 or lower. |
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What does the BE tell us?
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Base excess - positive indicates excess, negative indicates deficit.
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