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Clin Path Quiz 17/18
Lecture 18: Acids/Bases
| Question | Answer |
|---|---|
| normal blood pH of dogs and cats | 7.4 (+/- 0.05) |
| reasons blood pH can be altered | normal physiologic functions usually produce large large quantities of acids as by products, acids need to be buffered and/or excreted |
| what usually regulates blood pH? | kidneys or lungs |
| decreased blood pH | <7.3, acidemia |
| increased blood pH | >7.5, alkalemia |
| death may occur at what pHs? | less than 7.0 or greater than 7.8 |
| physiology | normal body functions produce acids bases, H+ ions are produced by digestion, increased conc of H- cause acidemia and need to be controlled |
| how does the body control pHs? | buffer systems (chemicals act instantaneously in the blood_), respiratory centers in the brain stem, kidneys |
| buffer systems (bicarbonate, phosphate, protein) | acts instantaneously, convert strong acids or bases into weak acids or bases, captures excess OH and H but CANNOT eliminate them |
| respiration | CO2 enters blood and combines with water to form carbonic acid and dissociates to become bicarbonate and H, lungs dispose of carbonic acid by exhaling CO2 |
| kidneys | critical in metabolic acid elimination (not carbonic acid), bicarbonate production and excretion occurs here |
| metabolic acidosis | decreased plasma bicarbonate, MOST COMMONLY SEEN acid-base disturbance; H+ is buffered by HCO3- and leads to a decrease in HCO3- |
| bicarbonate | metabolic base, main fluid buffer in the body, NOT routiney measured on in-house, measured as part of blood gas anaylisi; may measure as bicarbonate or total CO2 |
| anion gap | measured by Na+, K+, Cl-, HCO3-; any difference in charges is defined as the anion gap |
| electroneutrality | a state where cations = anions |
| anion gap values | (Na+ + K+) - (Cl- + HCO3-); normal canine 12-24 mEg/L, normal feline 13-27 mEq/L |
| increased anion gap | means inc concentration of unmeasured anions in the blood; includes ketones, lactate, renal acids, ethylene glycol metabolites (METABOLIC ACIDOSIS) |
| causes to metabolic acidosis | increased anion gap -> lactic acidosis, ketoacidosis, renal failure or post renal azotemia, ethylene glycol toxicity other causes -> hyperchloremia (GI loss of diarrhea, renal loss), secondary metabolic acidosis |
| metabolic alkalosis | inc bicarbonate or base excess; causes: GI loss of acids (vomiting, sequestration, pyloric outflow obstruction), renal loss (diuretics, hypokalemia) |
| partial pressure of CO2 (PCO2) | CO2 that is dissolved in blood, evaluates alveolar ventilation, sample is from arterial blood; NORMAL APPROX 40 mmHg |
| respiratory acidosis | inc PCO2, HYPOVENTILATION; causes: drugs, impaired gas exchange (pulmonary disease, restrictive disease) |
| respiratory alkalosis | dec PCO2, HYPERVENTILATION; causes: dec. blood oxygen, heat stroke, pain or anxiety, pulmonary disease |
| when do you measure acid/base status? | prolonged V/D, renal failure, respiratory distress, Addison's disease, diabetes mellitus |
| treatment for acid/base imbalances | fluid therapy to replace lost electrolytes and balance pH |
| acid base analyzers | basic analysis will report pH, PCO2, PO2; SAMPLE NEEDS TO BE ARTERIAL BLOOD |
| blood gas evaluation tips | 1) acidemia, alkalemia or normal? 2) do bicarbonate or PCO2- match the pH alteration? 3) once you decide was the primary acid/base disturbance is, evaluate other parameter |
| secondary acid/base disturbance | if other parameter is opposite of the pH alteration |
Created by:
mkroon26
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