WVSOM -- Physiology -- Acid Base
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| Once initial change is identified, what is determined next? | show 🗑
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| show | makes them pee out more phosphate
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| show | after a few hours
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| Whatn is chronic respiratory acidosis complete? | show 🗑
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| What happens during chronic respiratory acidosis? | show 🗑
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| show | COPD, CNS diseases that affect respiration, drugs that inhibit respiration and disease of respiratory muscles
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| show | serum proteins, hemoglobins and phosphates
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| What happens in acute respiratory alkalosis? | show 🗑
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| When is chronic respiratory alkalosis complete? | show 🗑
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| show | phsychogenic hyperventilation, altitude, improper use of mechanica ventilator, drugs (aspirin) fever
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| show | kidneys reduce H excretion and HCO3 is lost in urine
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| show | pregnancy because of increased metabolic demand
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| If there is a respiraotyr disorder what do you need to evaluate for? | show 🗑
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| show | Yes respiratory acidosis
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| A patient has a pH of 7.29, pCO2 of 65, pO2 of 55mm Hg and an HCO3 of 32 mEq/liter. Is compensation taking place and is it appropriate? | show 🗑
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| What causes metabolic acidosis? | show 🗑
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| What happens to equilibrium of the carbonic equation if there is an accumulation of acids? | show 🗑
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| show | equilibrium will shift right
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| What is the anion gap useful in discerning? | show 🗑
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| What is an anion gap? | show 🗑
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| Anion gap = | show 🗑
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| show | increased Cl-
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| What is normocholemic metabolic acidosis? | show 🗑
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| show | 9-16 mEq/L
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| show | hyperchloremic metabolic acidosis
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| What causes hyperchloremic metabolic acidosis? | show 🗑
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| How does the body compensate for hyperchloremic metabolic acidosis? | show 🗑
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| show | normochloremic metabolic acidosis
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| show | (mudpiles) Methanol, uremia, diabetic ketoacidosis, paraldehyde, insulin (lack of) lactic acidosis, ethylene glycol and salicyclic acid
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| show | hyperventilation and kidneys increase acid excretions (except with kidney failure)
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| What fluids have a pH of 7.35-7.45? | show 🗑
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| What fluids when loss could lead to alkalosis? | show 🗑
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| show | Liver bile, pancreatic juice, jejuna fluid, and ileal fluid
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| What are the two types of acids produced by physiological proceses? | show 🗑
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| show | carbonic acid because it can be converted to CO2
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| show | lungs
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| What are examples of Fixed acids? | show 🗑
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| show | kidneys
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| show | metabolism of carbs/fa/aa, anaerobic glycolysis, catabolism of phospholipids and nucleic acids
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| show | lactic acid
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| show | urea and h2o secreted, co2 blown off, ketone bodies
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| What does metabolism of carbs produce? | show 🗑
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| What does metabolism of AA produce? | show 🗑
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| What does catabolism of phospholipids and nucleic acids produce? | show 🗑
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| What processes consume H=? | show 🗑
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| show | proteins, cranberries, plums, prunes, tea and cocoa
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| show | citrus, tomatoes and vegetables
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| show | alkalizing because they don’t eat much meat and eat alkalizing foods
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| What do buffers do? | show 🗑
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| Do buffers prevent changes in pH? | show 🗑
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| What is most effective pKa? | show 🗑
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| show | exceeding capacity, response of kidneys and lungs, and compromised function of respiratory/renal systems
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| show | bicarb/CO2, inorganic/organic phosphates, proteins, bone
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| What is the first buffering systems in extra cellular fluid? | show 🗑
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| What is the first buffer in intracellurlar buffers? | show 🗑
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| What does bone formation do to pH? | show 🗑
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| What does bone resportion do to pH? | show 🗑
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| What enzyme makes physiologic process of bicarb/CO2 buffer system possible? | show 🗑
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| How do proteins act as buffers? | show 🗑
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| What is the buffering system in plasma? | show 🗑
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| show | bicarb/CO2 and inorganic phosphates
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| show | protien, organic phosphates, bicarb/CO2, phosphates
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| What is the buffer system in RBC? | show 🗑
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| show | hydroxyapatite and carbonate
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| show | 35-45
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| What is normal HCO3-? | show 🗑
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| show | 135-145 mEq/L
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| show | 3.5-5 mEq/L
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| What is normal Cl- venous value? | show 🗑
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| pH = ? | show 🗑
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| show | pH = pK + log[A-]/[HA}
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| show | bicarbante
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| show | PaCO2 to estimate H2CO3
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| show | 6.1
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| What is normal solubility of CO2? | show 🗑
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| If bicarb is 24 and PaCO2 is 40 what is the pH? | show 🗑
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| How do you figure out carbonic acid in H-H equation? | show 🗑
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| show | abnormal pH of the blood
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| show | it is respiratory or metabolic
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| show | PaCO3 is responsible for abnormal pH
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| What is responsible for a metabolic acid/base disorder? | show 🗑
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| What is a simple disorder? | show 🗑
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| What is a mixed(complex) acid/base disorder? Two or more primary disturbances in acid/base balance are present | show 🗑
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| show | yes, mixed alkalosis and acidosis
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| show | response to disturbance in acid/base balance in attempts to restor pH to normal
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| When will the body over compensate? | show 🗑
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| show | NO because they help prevent academia or alkalemia
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| show | respiratory and renal
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| What is respiratory compensation? | show 🗑
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| show | eliminate excess H+/HCO3-; regenerate HCO3; titratable acids/NH3:NH4
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| What is initial chemical change in respiratory acidosis? | show 🗑
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| What is the compensatory response to respiratory acidosis? | show 🗑
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| What is the initial chemical change in respiratory alkalosis? | show 🗑
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| show | decreased HCO3-
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| show | decreased HCO3
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| show | decreased PCO2
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| show | increased HCO3
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| show | increased PCO2
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| show | pH, PaCO3 and HCO3-
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| show | opposite directions
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| How do pH and HCO3- move in metabolic acid base disorders? | show 🗑
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| show | respiratory acidosis
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| show | metabolic acidosis. Not mixed. Anion gap is 10 (normal) so it is hypercholoremic metabolic acidosis
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| 22 y/o female with type I DM, presents with 1 day history of nausea, vomiting, polyuria, polydypsia and vague abdominal pain. Kussmaul resporations, dry mucous membranes. | show 🗑
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| What is delta ratio? | show 🗑
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| show | Δ in anion gap/ Δ[HCO3-]
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| show | when there is a metabolic acidosis with a high anion gap
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| What is a delta ratio of 1-2 mean? | show 🗑
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| If delta ratio < 1 what does that indicate? | show 🗑
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| If delta ratio is > 2 what does that indicate? | show 🗑
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| What is metabolic alkalosis associated with? | show 🗑
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| What results from accumulation of bicarb in plasma? | show 🗑
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| What causes metabolic acidosis? | show 🗑
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| show | hypoventilation and kidneys attempt to excrete excess bicarb
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| Patient has been sick for a week, vomiting several times every day. Dehydrated and fainted at work. pH 7.5, pCO2 43mmHg, PO2 95 mmHg, hemoglobin-O2 sat 97%, HCO3- 32 mEq/L. What is the acid base disorder? | show 🗑
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| What is the expected compensation in metabolic acidosis? | show 🗑
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| What is expected level of compensation in metabolic alkalsois? | show 🗑
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| show | hyperventilation, shift of oxyhemoglobin dissociation cure to the right and a decrease in 2,3DPG in RBG(after 6 hours of academia)
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| What are the cardiovascular effects of acidosis? | show 🗑
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| What are the effects of CNS with acidosis? | show 🗑
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| show | increased bone resoprtion
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| What happens to K+ in acidosis? | show 🗑
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| What happens to phosphate in acidosis? | show 🗑
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| show | sift of oxyhemoglobin dissociation cure to the left, increase in 2,3 DPG levels in RBC. Inhibition of respiratory drive via the central and peripheral chemoreceptors
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| What are the effects on the cardiovascular with alkalosis? | show 🗑
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| show | cerebral vasoconstriction leads to decreased blood flow and altered LOC.
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| What happens to H+ ions with alkalosis? | show 🗑
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| show | is moved into and out of cells to compensate for changes in H+
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| show | H+ moves out of the cell and K+ moves into the cells (Hypokalemia)
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| show | H+ moves into cells and K+ moves out resulting in hyper kalemia
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| show | thre are more anionic proteins so Ca bind sto it resulting in hypocalcemia
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| What happens with Ca++ in acidosis? | show 🗑
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Created by:
tjamrose
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