Msa A&p Exam 6

Front 1

what is a process that tends to lower ECF pH?

Back 1

acidosis

Front 2

what is metabolic acidosis?

Back 2

low HCO3

Front 3

what is respiratory acidosis?

Back 3

high PaCo2

Front 4

most cases acidosis leads to what?

Back 4

acidemia (decrease in blood pH)

Front 5

what is alkalosis?

Back 5

a process that tends to increase ECF pH

Front 6

what is high HCO3?

Back 6

metabolic alkalosis

Front 7

what is low PaCO2?

Back 7

respiratory alkalosis

Front 8

in most cases alkalosis leads to what?

Back 8

alkalemia (increase in blood pH)

Front 9

what are characteristics of metabolic acidosis?

Back 9

-reduced arterial pH (acidemia)
-reduced plasma (HCO3)

Front 10

what is response to metabolic acidosis?

Back 10

compensatory hyperventilation and decreased PaCO2

Front 11

what are some causes of metabolic acidosis?

Back 11

-inability to excrete dietary H+ load
(renal failure, hypoaldesteronism)

Front 12

what are some causes of increased H+ load or HCO3 loss?

Back 12

-lactic acidosis
-ketoacidosis
-diarrhea

Front 13

what is due to severe tissue hypoperfusion assoc w/ shock or cardiopulmonary arrest; seizures?

Back 13

lactic acidosis

Front 14

what is cause of HCO3 loss from intestine?

Back 14

diarrhea

Front 15

what are pulmonary symptoms of metabolic acidosis?

Back 15

-marked increase in minute ventilation-compensatory
-dyspnea, hyperpnea

Front 16

what are cardiac symptoms of metabolic acidosis?

Back 16

-reduction in ventricular contractility
-potentially fatal ventricular dysrhythmias

Front 17

what are neurologic symptoms of metabolic acidosis?

Back 17

symptoms range from lethargy to coma

Front 18

what is most important buffer response to acidemia?

Back 18

-extracellular buffering- HCO3 is most important buffer

Front 19

what are some other buffers for metabolic acidosis?

Back 19

-intracellular and bone buffering

Front 20

what is most important respiratory compensation for metabolic acidosis?

Back 20

-stimulation of peripheral and central chemoreceptors-increase in alveolar ventilation

Front 21

the increase in ventilation does what to try and compensate for metabolic acidosis?

Back 21

-decrease CO2 and allows CO2/HCO3 system to shift to the left

Front 22

on avg PaCO2 will fall how much for every 1.0meq/L in the plasma HCO3?

Back 22

1.2 mmHg

Front 23

PaCO2= ?

Back 23

(HCO3 x 1.5) + 8

Front 24

last two digits of the pH=?

Back 24

HCO3 + 15

Front 25

PaCO2 substantially different from predicted suggests what?

Back 25

a mixed acid-base disturbance

Front 26

what is renal compensation responsible for?

Back 26

-ultimately responsible for excreting excess H+ in order to correct ECF pH; requires several days

Front 27

what is principal compensatory response from renal system?

Back 27

increased tubular cell NH3 production and excretion of H+ as NH4--can exceed 250meq per day

Front 28

what are characteristics of respiratory acidosis?

Back 28

-reduced arterial pH (acidemia)
-elevation in PaCO2 (hypercapnia)
-variable increase in plasma HCO3

Front 29

becaue the CO2 stimulus to ventilation is so strong hypercapnia and resp acidosis are almost always due to what?

Back 29

a reduction in effective alveolar ventilation

Front 30

what are neurologic symptoms of acute hypercapnia?

Back 30

-HA
-blurred vision
-restlessness
-anxiety
-tremors
-delirium
-somnolence

Front 31

what are cardiovascular symptoms of acute hypercapnia?

Back 31

-dysrhythmias
-peripheral vasodilation

Front 32

is the CO2/HCO3 buffer a good buffer in the acute rsponse to resp acidosis?

Back 32

not an effective buffer in this situation

Front 33

what are some important intracellular buffers?

Back 33

Hgb and other protein important in buffering H+

Front 34

on avg there will be how much of rise in plasma HCO3 for every 10mmHG rise in PaCo2?

Back 34

1 meq/L

Front 35

persistent elevation of PaCO2 stimulates renal H+ secretion resulting in what?

Back 35

addition of HCO3 to the ECF

Front 36

after several days of acidosis a new steady-state is reached in which there is how many meq/L increase in plasma HCO3 for every how many mmHg rise in PaCo2?

Back 36

4 meq/L for every 10mmHg rise in PaCO2

Front 37

the extent of the increase in plasma HCO3 in chronic respiratory acidosis is determined by what?

Back 37

the extent to which renal H+ secretion increases

Front 38

what are characteristics of metabolic alkalosis?

Back 38

-elevation in arterial pH (alkalemia)
-increase in plasma HCO3
-compensatory hypoventilation resulting in a rise in PaCO2

Front 39

a rise in plasma HCO3 ususally results from what?

Back 39

H+ loss from the GI tract or in teh urine

Front 40

what are symptoms of metabolic alkalosis?

Back 40

-muscle cramps
-postural hypotension
-hypokalemia (muscle weakness)

Front 41

development of alkalemai is sensed by what?

Back 41

the peripheral chemoreceptors, resulting in a decline in ventilation and an appropriate increase in PaCO2

Front 42

an avg PaCO2 increases how much for every 1.0 meq/L increase in plasma HCO3?

Back 42

0.6 mmHg

Front 43

usually metabolic alkalosis is self limiting b/c why?

Back 43

kidneys excrete increase HCO3

Front 44

perpetuation of metabolic alkalosis requires what?

Back 44

some impairment in renal HCO3 excretion due to increased tubular HCO3

Front 45

what are some characteristics of respiratory alkalosis?

Back 45

-elevated arterial pH (alkalemia)
-elevated PaCO2 (hypocapnia)
-variable reduction in plasma HCO3

Front 46

what are neurologic symptoms of resp. alkalosis?

Back 46

-light-headedness
-altered consciousness
-syncope
(related to increased membrane excitability and impaired cerebral function)

Front 47

there is a reduction in cerebral blood flow by how much w/ resp alkalosis?

Back 47

35-40%

Front 48

what are cardiac symptoms of resp alkalosis?

Back 48

dysrhythmias

Front 49

what is another symptoms of resp alkalosis?

Back 49

hypokalemia

Front 50

what is an acute response to respiratory alkalosis?

Back 50

H+ move frm cells into the ECF, combine w/ HCO3 and cause an appropriate fall in plasma HCO3

Front 51

w/ resp alkalosis an avg plasma HCO3 is reduced by how much for each 10mmHg decrease in PaCO2?

Back 51

2 meq/L

Front 52

what is a chronic response to persistent hypocapnia in resp alkalosis?

Back 52

-compensatory decrease in renal H+ secretion
-increased urinary excretion of HCO3 and decreased NH4 excretion (lower plasma HCO3)

Front 53

when a steady state in resp alkalosis is reached how much is the plasma HCO3 reduced?

Back 53

by 5meq/L for each 10 mmHg decrease in PaCO2

Front 54

causes of metabolic acidosis- MUDPILES?

Back 54

M=methanol
U=Uremia
D=Diabetic ketoacidosis
P=paraldehyde, propylene glycol
I=infection, iron;ionized (INH)
L=Lactic acidosis
E= Ethylene Glycol r ethanol ing.
S= salicylates

Front 55

causes metabolic acidosis w/ nml anion gap= HARD UP?

Back 55

H=hyperalimentation (w/ TPN)
A=acetazolamine
R=RTA (renal tubule acidosis)
D=Diarrhea
U=ureterosigmoidostomy
P=pancreatic fistula