Acid-Base Balance and Disorders Quiz

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Questions and Answers

What is the normal respiratory response to metabolic alkalosis?

Decrease respiratory rate to retain CO2 (correct)

No change in respiratory rate

Increase respiratory rate to retain CO2

Increase respiratory rate to eliminate excess CO2

What limits the efficiency of respiratory compensation for metabolic alkalosis?

The necessity to increase oxygen uptake

The threshold for tolerable decreases in respiration rate (correct)

The speed of kidney response to pH changes

The amount of bicarbonate produced by kidneys

How do kidneys respond to respiratory acidosis?

Increase reabsorption of bicarbonate and decrease H+ secretion

Increase reabsorption of bicarbonate and increase H+ secretion (correct)

Decrease reabsorption of bicarbonate and increase H+ secretion

Decrease H+ secretion and reabsorb potassium

What mechanism do kidneys employ to regulate bicarbonate levels during respiratory alkalosis?

Decrease production of bicarbonate and reabsorb H+ Signup and view all the answers

What role do kidneys play in the long-term adjustment of blood pH?

They reabsorb acids and bases or excrete them into urine Signup and view all the answers

What serum sodium concentration defines hyponatremia?

< 135 mEq/L Signup and view all the answers

What is the serum sodium correction formula used to account for elevated glucose levels?

Corrected Na+ = Na+ + (excess glucose x 0.3) Signup and view all the answers

What factors can cause pseudo hyponatremia?

Excessive glucose Signup and view all the answers

What is the condition called with serum potassium level greater than 5 mmol/L?

Hyperkalemia Signup and view all the answers

How does hyperglycemia lead to a decrease in serum sodium concentration?

Water moves from intracellular to extracellular space Signup and view all the answers

What does a high anion gap typically indicate?

Metabolic acidosis Signup and view all the answers

In the calculation of the anion gap, which formula is used?

AG = (Na+) - (Cl- + HCO3-) Signup and view all the answers

What happens during hyperventilation in the context of acid-base balance?

Decreased blood levels of CO2 Signup and view all the answers

What is considered a normal anion gap range?

10-12 mmol/L Signup and view all the answers

Which of the following is NOT a cause of a high anion gap?

Dehydration Signup and view all the answers

Which condition is characterized by an increase in bicarbonate?

Metabolic alkalosis Signup and view all the answers

What physiological response occurs during metabolic acidosis?

Increased respiratory rate Signup and view all the answers

What defines acidosis in terms of pH levels?

pH < 7.35 Signup and view all the answers

What is the primary difference between intracellular fluid (ICF) and extracellular fluid (ECF)?

ICF is separated from ECF by the cell membrane. Signup and view all the answers

Which of the following best defines euvolemia?

Normal body fluid volume. Signup and view all the answers

What effect does hypervolemia have on body weight?

It causes weight gain. Signup and view all the answers

Which statement is true regarding osmotic pressure?

It must be applied to prevent osmosis. Signup and view all the answers

How does osmotic pressure relate to solubility?

It is a function of the number of dissolved particles. Signup and view all the answers

What is the relationship between osmolality and the concentration of particles in serum?

Higher osmolality indicates more particles in the serum. Signup and view all the answers

What best describes osmosis?

Movement of water from low to high solute concentration. Signup and view all the answers

What is the main characteristic of a colligative property?

It is determined by the number of dissolved particles. Signup and view all the answers

What pH level is indicative of metabolic acidosis?

7.15 Signup and view all the answers

In respiratory alkalosis, what would you expect the pCO2 level to be?

Less than 40 mm Hg Signup and view all the answers

Which condition is characterized by high bicarbonate levels and high pCO2?

Respiratory acidosis Signup and view all the answers

What indicates a mixed acid-base disorder?

Coexistence of multiple primary disorders Signup and view all the answers

If a patient shows a pH of 7.7 and [HCO3-] > 24 mmol/L, what condition are they likely experiencing?

Metabolic alkalosis Signup and view all the answers

What is the expected change in bicarbonate levels in response to a respiratory acidosis condition?

Decrease by 0.5 mmol/L Signup and view all the answers

Which of the following pH levels is consistent with respiratory acidosis?

7.15 Signup and view all the answers

What is the threshold for HCO3- levels that indicates metabolic acidosis?

Less than 24 mmol/L Signup and view all the answers

In metabolic alkalosis, how would the pCO2 levels typically present?

Increased pCO2 Signup and view all the answers

What response is expected in renal compensation during metabolic acidosis?

Increase in bicarbonate by 0.35 mmol/L Signup and view all the answers

Study Notes

Anion Gap (AG)

AG is the difference between the sum of the main anions and the sum of the main cations.
Formula: AG = (Na+ + K+) – (Cl- + HCO3-) or AG = (Na+) - (Cl- + HCO3-)
Normal AG is 10-12 mmol/L
High AG indicates metabolic acidosis.
Causes of high AG include ketoacidosis, lactic acidosis, intoxications, and renal failure.

Assessing Fluid and Electrolyte Disturbances

Factors to consider:
- Patient's weight
- Blood urea
- Blood glucose
- Electrolytes in serum and urine
- Osmolarity in blood and urine
- Osmolar gap

Acid-Base Balance and its Regulation

Stable [H+] in the body fluid is crucial for acid-base balance.

Acid-Base Disorders

Acidosis: High [H+] (pH < 7.35)
Alkalosis: Low [H+] (pH > 7.45)
Metabolic disorders are due to changes in bicarbonate (HCO3-):
- High HCO3-: metabolic alkalosis
- Low HCO3-: metabolic acidosis
Respiratory disorders are due to changes in pCO2:
- High pCO2: respiratory acidosis
- Low pCO2: respiratory alkalosis

Regulation of Acid-Base Imbalance

Compensation:
- Respiratory compensation: the lungs regulate blood levels of CO2.
  - Hyperventilation: eliminates more CO2, increasing pH.
  - Hypoventilation: accumulates CO2, decreasing pH.
  - Compensates for metabolic disorders.
- Renal compensation: the kidneys make long-term adjustments to pH.
  - Reabsorbs acids and bases or excretes them into urine.
  - Produces HCO3 to replenish lost supply.
  - Compensates for respiratory disorders.

Simple Acid-Base Disorders

Acidosis:
- Metabolic: Low HCO3-, low pCO2 (pH < 7.4)
- Respiratory: High CO2, high HCO3- (pH < 7.4)
Alkalosis:
- Metabolic: High HCO3-, high pCO2 (pH > 7.4)
- Respiratory: Low CO2, low HCO3- (pH > 7.4)
- Respiratory compensation is less efficient for alkalosis than for acidosis, as there is a limit to the decrease in respiration.

Mixed Acid-Base Disorders

Simultaneous occurrence of two or more primary acid-base disorders in the same patient.

Body Fluids

Intracellular fluid (ICF): 2/3 of total body fluid in adults.
Extracellular fluid (ECF): 1/3 of total body fluid.
Composition of ICF differs from that of ECF due to the cell membrane.

Euvolemia, Hypervolemia, Hypovolemia

Euvolemia: normal body fluid volume.
Hypervolemia: increased body fluid volume (weight gain).
Hypovolemia: decreased body fluid volume (weight loss).

Osmosis and Osmotic Pressure

Osmosis: diffusion of water (solvent) through a semi-permeable membrane from a solution of lower concentration (high concentration in water) to a solution of higher concentration (low concentration of water).
Osmotic pressure: pressure required to prevent osmosis. It depends on the molarity of the solution.

Osmolality and Osmolarity

Osmolality: number of osmoles of particles/Kg of solvent - expressed in mosmol/kg.
Higher osmolality means more particles in serum.

Pseudo Hyponatremia

Normal osmolality but decreased sodium.
Cause: hyperglycemia (glucose cannot enter cells, leading to water shifting from ICF to ECF).
Corrected sodium formula: Corrected Na+ = Na+ + (excess glucose x 0.3)

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Description

Test your knowledge on acid-base balance, anion gap, and electrolyte disturbances in this comprehensive quiz. Understand the principles behind metabolic and respiratory disorders and their implications in clinical settings.