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?

    <p>Decrease production of bicarbonate and reabsorb H+</p> Signup and view all the answers

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

    <p>They reabsorb acids and bases or excrete them into urine</p> Signup and view all the answers

    What serum sodium concentration defines hyponatremia?

    <p>&lt; 135 mEq/L</p> Signup and view all the answers

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

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

    What factors can cause pseudo hyponatremia?

    <p>Excessive glucose</p> Signup and view all the answers

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

    <p>Hyperkalemia</p> Signup and view all the answers

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

    <p>Water moves from intracellular to extracellular space</p> Signup and view all the answers

    What does a high anion gap typically indicate?

    <p>Metabolic acidosis</p> Signup and view all the answers

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

    <p>AG = (Na+) - (Cl- + HCO3-)</p> Signup and view all the answers

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

    <p>Decreased blood levels of CO2</p> Signup and view all the answers

    What is considered a normal anion gap range?

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

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

    <p>Dehydration</p> Signup and view all the answers

    Which condition is characterized by an increase in bicarbonate?

    <p>Metabolic alkalosis</p> Signup and view all the answers

    What physiological response occurs during metabolic acidosis?

    <p>Increased respiratory rate</p> Signup and view all the answers

    What defines acidosis in terms of pH levels?

    <p>pH &lt; 7.35</p> Signup and view all the answers

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

    <p>ICF is separated from ECF by the cell membrane.</p> Signup and view all the answers

    Which of the following best defines euvolemia?

    <p>Normal body fluid volume.</p> Signup and view all the answers

    What effect does hypervolemia have on body weight?

    <p>It causes weight gain.</p> Signup and view all the answers

    Which statement is true regarding osmotic pressure?

    <p>It must be applied to prevent osmosis.</p> Signup and view all the answers

    How does osmotic pressure relate to solubility?

    <p>It is a function of the number of dissolved particles.</p> Signup and view all the answers

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

    <p>Higher osmolality indicates more particles in the serum.</p> Signup and view all the answers

    What best describes osmosis?

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

    What is the main characteristic of a colligative property?

    <p>It is determined by the number of dissolved particles.</p> Signup and view all the answers

    What pH level is indicative of metabolic acidosis?

    <p>7.15</p> Signup and view all the answers

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

    <p>Less than 40 mm Hg</p> Signup and view all the answers

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

    <p>Respiratory acidosis</p> Signup and view all the answers

    What indicates a mixed acid-base disorder?

    <p>Coexistence of multiple primary disorders</p> 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?

    <p>Metabolic alkalosis</p> Signup and view all the answers

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

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

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

    <p>7.15</p> Signup and view all the answers

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

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

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

    <p>Increased pCO2</p> Signup and view all the answers

    What response is expected in renal compensation during metabolic acidosis?

    <p>Increase in bicarbonate by 0.35 mmol/L</p> 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.

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