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53 Cards in this Set
- Front
- Back
What is the normal arterial blood pH?
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7.35-7.45
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Arterial pH of less than 7.35 is the definition of?
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acidosis
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Arterial blood greater than 7.45 is the definition of?
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alkalosis
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Only a single acid base process and it's expected compensation are present is the definition of?
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simple disturbance
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Two or more primary acid base disturbances are present is the definition of?
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mixed disturbances
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When you are presented with mixed disturbances, what will the arterial pH depend on?
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the direction and magnitude of the disturbance
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The physiologic metabolic and respiratory changes to return the pH toward normal in response to a primary acidosis or alkalosis is the definition of?
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compensation
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True or False: normal pH = absence of acid base problems
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False
normal pH does not mean no acid base problems |
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When is compensation total or complete?
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when pH is corrected to normal
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What are the critical values of arterial blood pH?
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<7.2
>7.6 |
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What is the normal range for PaCO2?
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35-45 mmHg
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This value reflects the effectiveness of lung function and the body's ability to get rid of carbon dioxide
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PaCO2
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What is the normal values for PaO2?
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80-100 mmHg
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What is the critical value for PaO2?
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< 60 mmHg
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This indicates the amount of oxygen presented to the tissues?
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PaO2
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What is the normal range of bicarb?
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24-30 meq/L
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This reflects how well the kidney works
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Bicarb
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Low bicarb and low pH indicates what type of disorder?
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metabolic acidosis
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What is the compensatory response to metabolic acidosis?
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decrease pCO2
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Increase pH and increase bicarb indicates what type of disorder?
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metabolic alkalosis
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What is the compensatory response to metabolic alkalosis?
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increase pCO2
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Low pH and low pCO2 indicates what type of disorder?
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Respiratory acidosis
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What is the compensatory response to respiratory acidosis?
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increase bicarb
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High pH and low pCO2 indicates what type of disorder?
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Respiratory alkalosis
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What is the compensatory response to respiratory alkalosis?
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decrease bicarb
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What is the normal value for the anion gap?
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10 + or - 2 mmol/L
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What anions are used to measure the anion gap?
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Na, Cl, bicarb
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What are the unmeasured anions?
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albumin, phosphates, sulfates, organic anions
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True or False: diabetic ketoacidosis can cause a high anion gap
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True
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What does a high anion gap indicate?
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metabolic acidosis
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True or False: alcoholic ketolactic is not a cause of high anion gap
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False
alcoholic ketolactic acid can cause high anion gap |
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What are the toxins that can cause high anion gap?
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methanol, ethylene glycol, salicylate, paraldehyde
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True or False: only lactic acidosis can cause high anion gap
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False:
diabetic ketoacidosis, alcoholic ketoacidosis, lactic acidosis, renal failure and toxins can all cause high anion gap |
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True or False: Hyperchloremia with a normal anion gap value indicates metabolic acidosis
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True
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What can cause lactic acidosis?
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increased tissue lactate production
decreased lactate utilization |
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What can cause an increase tissue lactate production?
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congenital defects
tissue hypoxia enhanced metabolic rate |
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What can cause decreased lactate utilization?
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hypoperfusion
liver disease ethanol intoxification |
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What are the major causes of hyperchloremic metabolic acidosis?
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GI bicarb loss
Acid gain |
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What can cause GI bicarb loss?
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diarrhea, pancreatic drainage, ureteral diversion
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What can cause acid gain?
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hyperalimentation fluids, ammonium chloride ingestion
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hyperventilation is a sign/symptom of what acid-base imbalance?
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metabolic acidosis
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Patient has pH=7.31, pO2 = 95 mmHg, pCO2 = 37 mmHg, bicarb = 15 mmHg
Labs show: Na 135, K 3.8, Cl 105, BUN 30, creat 1.8 What is a likely disorder that the patient may have? |
metabolic acidosis
low pH, low bicarb indicates metabolic acidosis |
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How do you treat metabolic acidosis?
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giving bicarb or citrate/acetate solutions
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What is type of compensation is faster, lungs or kidney?
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lungs
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What are the causes of respiratory acidosis?
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impaired alveolar gas exchange
COPD disorders of respiratory muscles inhibition of brain respiratory center |
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What does the patient likely have:
pH 7.38, pCO2 50, pO2 50, bicarb 30 |
respiratory acidosis
normal pH, but high pCO2 and high bicarb indicates respiratory acidosis |
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What is metabolic acidosis almost always secondary to?
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volume contration
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What does the patient likely have:
pH 7.38, pCO2 50, pO2 50, bicarb 30 |
respiratory acidosis
normal pH, but high pCO2 and high bicarb indicates respiratory acidosis |
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True or False: in patients with metabolic alkalosis, increase in bicarb is related to abnormal renal bicarb absorption
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True
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How do you treat metabolic alkalosis?
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fluid replacement
acetazolamide HCL ammonium chloride |
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Is HCl the first line of treatment for metabolic alkalosis?
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no, it is used in the worst case scenario
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What are the causes of respiratory alkalosis?
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hypoxemia
pulmonary disease stimulation of respiratory center in brain over-ventilation |
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How do you treat respiratory alkalosis?
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treat underlying disorder
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