Question 1

normal PH (and relative normal)

Accepted Answer

normal PH 7.35-7.45 
however, if other values are deranged, and compensation exists, take 7.4 as the relative normal

Question 2

normal HCO3 (bicarbonate) levels:

Accepted Answer

22-26mm/l

Question 3

normal PaO2 levels

Accepted Answer

80-105% on R/A

Question 4

Normal PaCO2 levels

Accepted Answer

35-45mm/l

Question 5

what is the first golden rule for analysing blood gas (to figure out if it is respiratory or metabolic)

Accepted Answer

If the PCO2 is moving in the opposite direction than the PH then it is respiratory / but if the HCO3 is moving in the same direction as the PH then it is metabolic

Question 6

what is the primary cause of respiratory acidosis?

Accepted Answer

Decreased/ impaired ventilation and or respiration leading to retention of CO2

Question 7

what are some common causes of respiratory acidosis?

Accepted Answer

COPD, APO, pneumonia, asthma, hypoventilation from any cause eg: shallow breathing and or dereased rate associated with brain stem injury, barbiuates and benzo's and opioids, airways obstruction or chest injury impairing adequate ventilation

Question 8

what is the primary cause of metabolic acidosis?

Accepted Answer

excessive loss of HC03 OR excessive production of acids, OR imability to excrete metabolic acids

Question 9

what are some common causes of metabolic acidosis?

Accepted Answer

excess loss of HCO3 from the intestines due to diarrhoea / circulatory shock, hypovoleamia (anaerobic metabolism and hypoperfusion produce >H+), renal failure or dx, DKA, starvation (ketones), >ECF K+, lactic acid production eg: anearaboic metabolism

Question 10

what is the primary cause of respiratory alkalosis?

Accepted Answer

the direct cause is always hyperventilation: eg blowing off excessive amounts of CO2

Question 11

what are some common causes of respiratory alkalosis?

Accepted Answer

excessive mechanical ventilation, pulmonary lesions, brain tumours or injury, acute anxiety, asthma

Question 12

what is the primary cause of metabolic alkalosis?

Accepted Answer

excess HCO3 or excessive loss of H+

Question 13

what are some common causes of metabolic alkalosis?

Accepted Answer

severe vomiting with a loss of HCL (H+ CL-), excessive gastric suctioning, excessive use of K+ sparing diuretics, other diuretics, ingesting excessive NaHCO3, hyperaldosteroneamia,

Question 14

describe the relationship between K+ and acid base balance in acidosis

Accepted Answer

In high circulating H+, intracellular K+ can act as a buffering system = K+ can diffuse into the ECF in exchange for H+. this can lead to hyperkaleamia, which in many cases would be restored to normal by urinary excretion, but may not in renal impairment

Question 15

describe the relationship between K+ and acid base balance in alkalosis:

Accepted Answer

where there is low circulating H+, H+ can diffuse out of the cells to buffer HCO3 levels. it is exchanged for K+ from the ECF to maintain membrane polarisation. can lead to hypokaleamia, confusion and arrythmias

Question 16

describe the sx of respiratory acidosis

Accepted Answer

many of the sx relate to the underlying resp disorder + to hypoxia. usually: resp distress, may be confusion, somolance, neurological sx reflect hypercapnia w cerebral vasodilation, tachycardia: sympathetic stimulation

Question 17

describe the sx of metabolic acidosis

Accepted Answer

dependant on the underlying cause. rsp changes to blow off CO2 eg: in DKA often accompanied by kusmauls resps. may present with muscle weakness, headache, general unwell, N and V, CP, ecg change

Question 18

describe the sx of respiratory alkalosis

Accepted Answer

dependant to a large part on underlying cause. however, as acute hypocapnia can lead to vaso constriction may be sx such as numbness, tingling and tetany, even in the abscence of hypoxia

Question 19

describe the sx of metabolic alkalosis

Accepted Answer

sx are also dependant on underlying illness/issue. but often is associated with hypokaleamia so there will be sx of that incl: weakness, myalgia and arthymia;s also decrease in rate and depth of breathing as resp centre becomes depressed

Question	Answer
normal PH (and relative normal)	normal PH 7.35-7.45 however, if other values are deranged, and compensation exists, take 7.4 as the relative normal
normal HCO3 (bicarbonate) levels:	22-26mm/l
normal PaO2 levels	80-105% on R/A
Normal PaCO2 levels	35-45mm/l
what is the first golden rule for analysing blood gas (to figure out if it is respiratory or metabolic)	If the PCO2 is moving in the opposite direction than the PH then it is respiratory / but if the HCO3 is moving in the same direction as the PH then it is metabolic
what is the primary cause of respiratory acidosis?	Decreased/ impaired ventilation and or respiration leading to retention of CO2
what are some common causes of respiratory acidosis?	COPD, APO, pneumonia, asthma, hypoventilation from any cause eg: shallow breathing and or dereased rate associated with brain stem injury, barbiuates and benzo's and opioids, airways obstruction or chest injury impairing adequate ventilation
what is the primary cause of metabolic acidosis?	excessive loss of HC03 OR excessive production of acids, OR imability to excrete metabolic acids
what are some common causes of metabolic acidosis?	excess loss of HCO3 from the intestines due to diarrhoea / circulatory shock, hypovoleamia (anaerobic metabolism and hypoperfusion produce >H+), renal failure or dx, DKA, starvation (ketones), >ECF K+, lactic acid production eg: anearaboic metabolism
what is the primary cause of respiratory alkalosis?	the direct cause is always hyperventilation: eg blowing off excessive amounts of CO2
what are some common causes of respiratory alkalosis?	excessive mechanical ventilation, pulmonary lesions, brain tumours or injury, acute anxiety, asthma
what is the primary cause of metabolic alkalosis?	excess HCO3 or excessive loss of H+
what are some common causes of metabolic alkalosis?	severe vomiting with a loss of HCL (H+ CL-), excessive gastric suctioning, excessive use of K+ sparing diuretics, other diuretics, ingesting excessive NaHCO3, hyperaldosteroneamia,
describe the relationship between K+ and acid base balance in acidosis	In high circulating H+, intracellular K+ can act as a buffering system = K+ can diffuse into the ECF in exchange for H+. this can lead to hyperkaleamia, which in many cases would be restored to normal by urinary excretion, but may not in renal impairment
describe the relationship between K+ and acid base balance in alkalosis:	where there is low circulating H+, H+ can diffuse out of the cells to buffer HCO3 levels. it is exchanged for K+ from the ECF to maintain membrane polarisation. can lead to hypokaleamia, confusion and arrythmias
describe the sx of respiratory acidosis	many of the sx relate to the underlying resp disorder + to hypoxia. usually: resp distress, may be confusion, somolance, neurological sx reflect hypercapnia w cerebral vasodilation, tachycardia: sympathetic stimulation
describe the sx of metabolic acidosis	dependant on the underlying cause. rsp changes to blow off CO2 eg: in DKA often accompanied by kusmauls resps. may present with muscle weakness, headache, general unwell, N and V, CP, ecg change
describe the sx of respiratory alkalosis	dependant to a large part on underlying cause. however, as acute hypocapnia can lead to vaso constriction may be sx such as numbness, tingling and tetany, even in the abscence of hypoxia
describe the sx of metabolic alkalosis	sx are also dependant on underlying illness/issue. but often is associated with hypokaleamia so there will be sx of that incl: weakness, myalgia and arthymia;s also decrease in rate and depth of breathing as resp centre becomes depressed

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VBG and acid base