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65 Cards in this Set
- Front
- Back
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pH alk PCO2 less than 40
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Respiratory Alkalosis
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pH alk PCO2 greater than or equal to 40
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Metabolic Alkalosis
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pH acidodic PCO2 less than or equal to 40
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Metabolic acidosis
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pH acidodic PCO2 greater than 40
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Respiratory acidosis
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pH acidodic and bicarb level less than normal
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Metabolic acidosis
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pH alkelemic and bicarb level greater than normal (24)
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Metabolic alkalosis
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What do strong electrolytes do in solution?
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Completly dissociate
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If pH increases, the concentration of H ions does what?
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Decreases
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What is Ka?
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The acid dissociation constant
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H2CO3 is one example of a
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Volatile acid
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Inorganic phosphoric or sulfuric acid, ketoacid, lactice acid, pyruvic acid are all examples of
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Non-volatile acids (or bases)
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What has a gaseous component with which they are in equilibrium, and is excreted via the lungs?
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Volatile acid (or base)
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What causes the urine to be acidic, is thus excreted via the kidneys, and is not in equilibrium w/ gas phase and may be organic or inorganic
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Non-volatile acids (or bases)
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Do we generate more acids via volatile or non-volatile acids in a given day?
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Volatile = 14 moles per day
non-volatile 60 millimoles per day |
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How can buffering power be calculated?
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amount of base added/chg in pH
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General definition of acid and base.
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Acid is a proton donor
Base is a proton acceptor |
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Acid can dissociate to
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a proton and a conjugate base
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What completly dissociates at a neutral pH?
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Strong Acid
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In the Henderson Hasselbach equation, pH =
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pH = pK'+log[HCO3]/αPCO2
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What does α represent in the Henderson Hasselbach equation?
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α is the solubility coefficient
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What is [HCO3][H]/αPCO2=
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Its the dissociation constant K'
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In human plasma what are the accepted values for the following:
Na Cl HCO3 PCO2 α pK' |
Na = 140 mM Na
Cl = 104 mM Cl HCO3 = 24mM PCO2 = 40mmHg α = 0.03mM/mmHg pK' = 6.1 |
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What is the anion gap equation?
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Na - Cl - HCO3 = 10 to 14
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What type of buffer is a better buffer even if pH is well away from its pK'?
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Open buffer
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Type of buffer: Its protonated form is held constant
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Open buffer
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Type of buffer: Total buffering concentration is allowed to vary
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Open buffer
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What is one example of an open buffer?
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CO2 in blood
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Why are weak acids and bases good buffers?
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Because they can react with H or OH ions and therefore minimize pH changes
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Buffering power (β) in a multiunit buffer is equal to:
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the sum of all β's
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What type of buffer's total concentration of buffering acid is constant?
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Closed buffer
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What type of buffer's effectiveness is influenced by the concentration of the buffer and proximity of its pK' to the pH of the soln?
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Closed buffer
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Weak _____ become better buffers as the pH increases relative to pK'.
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acids
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Weak ______ become better buffers as the pH decreases relative to pK'
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bases
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Good buffers for blood have what type of group?
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Imidazole
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The fact that in a mixture of buffers, each obeys its own Henderson Hasselbach equation is known as:
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Isohydric Principle
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Describe a graph of pH and HCO3 content.
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CO2 isobar and non bicarbonate buffer line
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In metabolic acidosis and alkalosis the primary change is:
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HCO3 content
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In te pH bicarbonate diagram, in the CO2 isobar, Pco2 is
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maintained
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What are the three ways to regulate pH?
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Buffering
Renal Compensation Respiratory Compensation |
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Respiratory acidosis
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increased Pco2
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Respiratory alkalosis
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decreased Pco2
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Metabolic acidosis
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decreased HCO3
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Metabolic alkalosis
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increased HCO3
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In metabolic acidosis, hyperventilation can cause:
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respiratory alkalosis
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In metabolic alkalosis, hypoventilation can cause:
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respiratory acidosis
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What is the major compensatory organ for respiratory disorders and non-renal metabolic disorders?
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Kidney
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anion gap with respiratory alkalosis may suggest
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asprin overdose or sepsis
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Organic nonvolatile acids
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ketoacid, lactic acid,
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Inorganic nonvolatile acids
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phosphoric and sulfuric acids
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At buffering max w/ closed buffer
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pka = pH
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What structure senses ph
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carotid body
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What is the BEST determination of the normal anion gap for a patient?
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Recent electrolyte levels that may have been measured when the patients acid-base balance was normal.
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Unmeasured anions include:
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K=4.5
Ca=5 Mg=11 |
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CNS depression
Pleural disease Lung disease Musculoskeletal disorders |
Causes of respiratory acidosis
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Renal failure
Ketoacidosis Drugs or poison Lactic acidosis |
Differential diagnosis for anion gap metabolic acidosis
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What can develop as a response to renal compensation for respiratory alkalosis
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Non anion gap acidosis
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Secondary to volume contraction or hypokalemia
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Metabolic alkalosis
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Caused by gi bicarb loss or altered renal fx
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non-anion gap acidosis
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Renal compensation is generally at its max when?
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4 days
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Chronic respiratory acidosis implies only that the disorder has existed for
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hours to a few days
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The following can cause what?
Catestrophic CNS disorder Drug use Pregnancy Decreased lung compliance Anxiety Cirrhosis of the liver Sepsis |
Respiratory alkalosis
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If a patient has diabetic ketoacidosis w. concommitant primary respiratory alkalosis..
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the have sepsis until proven otherwise
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When is sepsis an unlikely cause
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non-anion gap acidosis
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A subnormal PaCO2 indicates
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a concominant primary alkalosis
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If corrected bicarb is greater than 24...
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concommitant primary metabolic alkalosis
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