Acid-Base Balance Quiz: Metabolic and Respiratory Disorders

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Questions and Answers

Which condition can lead to metabolic acidosis due to renal failure?

Overuse of antacids

Excessive adrenocorticoid hormones

Diabetic Ketoacidosis (correct)

Vomiting

What is a clinical feature typically associated with metabolic alkalosis?

Cold and clammy skin

Increased respiratory rate

Confusion

Hypokalemia (correct)

What is the normal range for PaCO2 in mm Hg?

35 to 45 (correct)

40 to 50

45 to 55

30 to 40

Which of the following is a cause of metabolic alkalosis?

Vomiting Signup and view all the answers

Which condition is characterized by low pH and high PaCO2?

Respiratory acidosis Signup and view all the answers

In metabolic acidosis, what happens to pH levels?

Decreases below 7.35 Signup and view all the answers

Which of the following conditions may lead to respiratory acidosis due to hypoventilation?

Pneumothorax Signup and view all the answers

Which statement is true regarding the respiratory compensation in metabolic acidosis?

Increased respiratory rate aims to eliminate CO2 Signup and view all the answers

What is the relationship between bicarbonate (HCO3) levels and metabolic alkalosis?

HCO3 levels are high Signup and view all the answers

In respiratory alkalosis, what happens to the PaCO2 levels?

PaCO2 decreases Signup and view all the answers

What is the normal blood pH level range considered healthy?

7.35 to 7.45 Signup and view all the answers

What describes a condition of acidosis?

Increase in hydrogen ion concentration Signup and view all the answers

Which mechanism is NOT involved in regulating acid-base balance?

Gastrointestinal absorption Signup and view all the answers

Which statement best describes buffers in acid-base balance?

They prevent large changes in hydrogen ion concentration. Signup and view all the answers

What is an effect of severe acidosis?

Loss of consciousness Signup and view all the answers

The phosphate buffering system is particularly significant in which location?

Intracellular fluid (ICF) Signup and view all the answers

How do bases interact with hydrogen ions?

They elevate pH levels by removing hydrogen ions. Signup and view all the answers

Which of the following is a primary extracellular buffer?

Carbonic acid/bicarbonate Signup and view all the answers

What is the primary role of the protein buffer system in the body?

To account for 75% of chemical buffering of body fluids Signup and view all the answers

What happens to pH levels as carbon dioxide levels increase?

pH decreases Signup and view all the answers

Which of the following statements about renal regulation of acid-base balance is TRUE?

Increased H+ secretion occurs when body fluid pH decreases Signup and view all the answers

What defines the normal pH range in arterial blood gas measurements?

7.35 to 7.45 Signup and view all the answers

What occurs when carbon dioxide levels decrease in the extracellular fluid?

pH increases Signup and view all the answers

What is the normal range for arterial oxygen saturation (SaO2)?

95% to 100% Signup and view all the answers

Which condition leads to an increase in the rate and depth of respirations?

Increased carbon dioxide extracellular levels Signup and view all the answers

How do the kidneys respond when urine pH falls below 4.5?

Inhibit hydrogen ion secretion Signup and view all the answers

Study Notes

Acid-Base Imbalances

Acid-base balance is regulated by buffers, renal and respiratory mechanisms
Buffers include phosphate, hemoglobin, and carbonate
Renal mechanism involves the kidneys
Respiratory mechanism involves the lungs

Classification of Acid-Base Imbalances

Respiratory acidosis: low pH, high PCO2
Respiratory alkalosis: high pH, low PCO2
Metabolic acidosis: low pH, low HCO3
Metabolic alkalosis: high pH, high HCO3

Interpretation of Arterial Blood Gases (ABGs)

ABGs provide values for pH, PaO2, PaCO2, and HCO3
pH measures acidity/alkalinity based on hydrogen ions (H+)
Normal pH range is 7.35 to 7.45
PaO2 is the partial pressure of oxygen in arterial blood
Normal PaO2 range is 80 to 100 mm Hg
PaCO2 is the amount of carbon dioxide in arterial blood
Normal PaCO2 range is 35 to 45 mm Hg
HCO3 is the calculated amount of bicarbonate in the blood
Normal HCO3 range is 22 to 26 mEq/L

Definitions of Acid-Base Imbalances

Metabolic acidosis: low pH and low bicarbonate
Metabolic alkalosis: high pH and high bicarbonate
Respiratory acidosis: low pH and high PaCO2
Respiratory alkalosis: high pH and low PaCO2

Imbalance	pH	PaCO2	HCO3
Respiratory acidosis	↓	↑	Normal
Respiratory alkalosis	↑	↓	Normal
Metabolic acidosis	↓	Normal	↓
Metabolic alkalosis	↑	Normal	↑

Causes of Respiratory Acidosis

Hypoventilation
Acute pulmonary edema
Aspiration of foreign object
Atelectasis
Pneumothorax
Overdose of sedatives
Sleep apnea syndrome
Chest trauma
COPD
Neuromuscular disease

Clinical Features of Respiratory Acidosis

Hypercapnia (elevated PaCO2)
Increased pulse
Increased respiratory rate
Increased blood pressure
Mental cloudiness
Feeling of fullness in the head
Cerebrovascular vasodilation
Ventricular fibrillation
Papilledema
Dilated conjunctival blood vessels
Hyperkalemia
Cyanosis
Tachypnea

Causes of Respiratory Alkalosis

Hyperventilation
Anxiety
Hypoxia
High altitude
Excessive ventilator assistance
Pregnancy
Fever
Initial stage of pulmonary embolus

Clinical features of Respiratory Alkalosis

(none listed)

Causes of Metabolic Acidosis

Diabetic ketoacidosis
Diarrhea
Salicylate overdose
Renal failure

Clinical Features of Metabolic Acidosis

Headache
Confusion
Drowsiness
Increased respiratory rate and depth
Nausea and vomiting
Decreased cardiac output
Decreased blood pressure, cold and clammy skin
Dysrhythmias
Shock

Causes of Metabolic Alkalosis

Loss of gastric secretions
Overuse of antacids
Potassium-wasting diuretics (thiazides, furosemide)
Excessive adrenocorticoid hormones

Clinical Features of Metabolic Alkalosis

Tingling of fingers and toes
Dizziness
Hypertonic muscles
Tachycardia
High pH (above 7.6) -
Hypokalemia
Premature ventricular contractions

Buffer Systems

Buffers resist changes in pH
Buffers remove added H+ ions
Buffers replace removed H+ ions
Types of buffer systems include carbonic acid/bicarbonate, phosphate, and protein

Bicarbonate Buffer System

CO2 + H2O → H2CO3 → H+ + HCO3-
Main extra cellular buffer
Affected by lungs and kidneys

Phosphate Buffer System

Stronger than bicarbonate
Important in ICF and renal tubules
Its components are Dihydrogen phosphate, Monohydrogen phosphate

Protein Buffer System

Proteins are the most concentrated buffer type in the body accounting for 75% of all chemical buffering in the body fluids.
Proteins act as buffers in both extracellular and intracellular fluids

Regulation of Acid-Base Balance by the Respiratory System

Regulates pH by adjusting CO2 levels in blood
Increased CO2 leads to decreased pH (acidosis)
Decreased CO2 leads to increased pH (alkalosis)

Regulation of Acid-Base Balance by the Renal System

Secretion of H+ into filtrate and reabsorption of HCO3- into ECF to regulate pH, by controlling extracellular fluid.
Rate of H+ secretion increases with decreased body fluid pH or increased aldosterone levels.
Secretion of H+ is inhibited when urine pH drops below 4.5.

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Description

Test your knowledge on the acid-base balance in the human body. This quiz covers topics related to metabolic and respiratory acidosis and alkalosis, including causes, clinical features, and compensatory mechanisms. Perfect for students in health sciences and medicine.