Acid-Base Disturbance Overview
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Questions and Answers

What is the primary acid-base imbalance indicated by the blood gas results?

  • Metabolic acidosis
  • Respiratory alkalosis
  • Respiratory acidosis
  • Metabolic alkalosis (correct)
  • Which condition could lead to metabolic alkalosis due to excessive loss of hydrogen ions?

  • Vomiting (correct)
  • Excessive exercise
  • Chronic bronchitis
  • Severe diarrhea
  • What indicates that there is partial compensation in the patient's acid-base status?

  • Abnormal PCo levels
  • An expected fall in pH
  • Normal pH levels
  • High bicarbonate levels (correct)
  • What does a pH of 7.5 indicate in the context provided?

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

    What is a common symptom associated with metabolic alkalosis?

    <p>Muscle cramps</p> Signup and view all the answers

    What underlying condition is associated with increased reabsorption of bicarbonate leading to metabolic alkalosis?

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

    What is a potential cause of respiratory alkalosis?

    <p>Hyperventilation of psychogenic origin</p> Signup and view all the answers

    Which of the following parameters indicates respiratory alkalosis in the provided case study?

    <p>Decreased PCO2 levels</p> Signup and view all the answers

    What clinical symptom might a patient experience due to respiratory alkalosis?

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

    In assessing compensation in acid-base disturbances, what should be evaluated?

    <p>Serum bicarbonate and carbon dioxide levels</p> Signup and view all the answers

    What is the primary interpretation of the blood gas results presented?

    <p>Fully compensated respiratory acidosis</p> Signup and view all the answers

    Which of the following is NOT a cause of respiratory acidosis?

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

    What clinical symptoms may indicate respiratory acidosis in a patient?

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

    What blood gas finding is indicative of hypoxia in the context of acid-base disturbances?

    <p>Low PO2</p> Signup and view all the answers

    Which condition among the following should be considered a likely underlying issue for respiratory acidosis?

    <p>Obstructive sleep apnea</p> Signup and view all the answers

    What is the primary condition indicated by the blood gas results?

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

    Which of the following is NOT a cause of metabolic acidosis?

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

    What is the normal range of anion gap in the human body?

    <p>12 +/- 4</p> Signup and view all the answers

    Which clinical feature is associated with metabolic acidosis?

    <p>Deep, rapid respiration</p> Signup and view all the answers

    How is the anion gap calculated?

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

    What is the anion gap calculated from the patient's serum electrolytes?

    <p>30</p> Signup and view all the answers

    What physiological effect can metabolic acidosis have on cardiac function?

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

    In which of the following conditions is an increased anion gap likely observed?

    <p>Chronic kidney disease</p> Signup and view all the answers

    What is the pH level associated with acidemia?

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

    Which condition is characterized by a pH level greater than 7.45?

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

    What compensatory mechanism occurs in metabolic acidosis?

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

    How does the body respond to respiratory alkalosis in the short term?

    <p>H ions moving from intracellular to extracellular fluids</p> Signup and view all the answers

    What is the normal range for arterial blood gas pH?

    <p>7.35 – 7.45</p> Signup and view all the answers

    Which of the following disorders is most likely associated with low HCO3 levels?

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

    What is the main driving force behind respiratory compensation in acidosis?

    <p>Elimination of carbon dioxide</p> Signup and view all the answers

    What blood gas value indicates respiratory acidosis?

    <p>High Pco2 and low pH</p> Signup and view all the answers

    In metabolic alkalosis, what compensatory mechanism is typically employed by the body?

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

    Which primary type of acid-base disturbance occurs due to ventilatory issues?

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

    What is the Pco2 normal range in arterial blood gas measurements?

    <p>35 - 45 mmHg</p> Signup and view all the answers

    In respiratory acidosis, how does the kidney compensate in the long term?

    <p>Increase bicarbonate reabsorption</p> Signup and view all the answers

    What physiological process predominantly occurs during metabolic acidosis?

    <p>Decreased bicarbonate</p> Signup and view all the answers

    Which condition is characterized by a decrease in HCO3 due to an acid-base imbalance?

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

    Study Notes

    Acid-Base Disturbance

    • Acid-base disturbances are imbalances in the body's pH levels.
    • Normal pH levels are between 7.35 and 7.45.
    • Acidemia is when the blood pH is below 7.35.
    • Alkalemia is when the blood pH is above 7.45.
    • The formula for calculating hydrogen ion concentration ([H]) is: [H] = 24 * Pco2 / [Hco3].
    • Acidemia is associated with an increase in hydrogen ion concentration ([H]), partial pressure of carbon dioxide (Pco2), and bicarbonate (Hco3).
    • Alkalemia is associated with a decrease in hydrogen ion concentration ([H]), partial pressure of carbon dioxide (Pco2), and bicarbonate (Hco3).

    Types of Acid-Base Disturbances

    • There are two main types of acid-base disturbances: respiratory and metabolic.

    Respiratory Acid-Base Disturbances

    • Respiratory acidosis is when the body cannot effectively get rid of carbon dioxide (CO2).
    • This leads to an increase in Pco2.
    • Respiratory alkalosis is when the body gets rid of too much CO2.
    • This leads to a decrease in Pco2.

    Metabolic Acid-Base Disturbances

    • Metabolic acidosis is when the body has a build-up of acids other than CO2.
    • This leads to a decrease in bicarbonate (HCO3-).
    • Metabolic alkalosis is when the body has a loss of acid or an increase in the amount of bicarbonate.
    • This leads to an increase in HCO3-.

    Compensation Mechanisms

    • The body has compensation mechanisms to help maintain normal pH levels.
    • Respiratory compensation involves changes in breathing rate and depth to alter Pco2.
    • Metabolic compensation involves the kidneys adjusting HCO3- levels.

    Respiratory Compensation for Metabolic Disorders

    • Metabolic acidosis leads to increased breathing rate (hyperventilation) to reduce Pco2 levels. This is known as Kussmaul breathing.
    • Metabolic alkalosis leads to decreased breathing rate (hypoventilation) to increase Pco2 levels.

    Metabolic Compensation for Respiratory Disorders

    • Respiratory acidosis leads to increased HCO3- levels through buffering systems, primarily hemoglobin.
    • Renal excretion of hydrogen ions also helps increase HCO3-.
    • Respiratory alkalosis is compensated by the kidneys lowering hydrogen ion secretion in the initial 10 minutes.
    • In the following 2-6 hours, the kidneys will further compensate by lowering hydrogen ion secretion.

    Interpretation of Arterial Blood Gas (ABG) Results

    • The first step in interpreting ABG results is assessing the pH level.
    • Next, examine bicarbonate and carbon dioxide levels to determine their ranges (normal or abnormal).
    • Evaluate if appropriate compensation is occurring by the body.
    • Finally, determine if the disturbance is alkalosis or acidosis.

    Case Studies

    Case 1

    • Newborn with respiratory distress
    • ABG results:
      • pH: 7.5 (high)
      • Pco2: 20 mmHg (low)
      • HCO3: 18 mEq/L (low)
    • Interpretation: Non-compensated respiratory alkalosis

    Case 2

    • Child with repeated vomiting
    • ABG results:
      • pH: 7.49 (high)
      • Pco2: 45 mmHg (high)
      • HCO3: 35 mEq/L (high)
    • Interpretation: Partially compensated metabolic alkalosis

    Case 3

    • Man with bronchial asthma
    • ABG results:
      • pH: 7.35 (normal)
      • Pco2: 65 mmHg (high)
      • HCO3: 28 mEq/L (normal)
    • Interpretation: Fully compensated respiratory acidosis

    Case 4

    • Newborn with poor feeding and lethargy
    • ABG results:
      • pH: 7.2 (low)
      • Pco2: 20 mmHg (low)
      • HCO3: 15 mEq/L (low)
    • Interpretation: Partially compensated metabolic acidosis

    Anion Gap

    • Anion gap is a calculation that helps differentiate between metabolic acidosis with an increased anion gap and metabolic acidosis with a normal anion gap.
    • The formula for anion gap is: Anion gap = Na - (HCO3 + Cl)
    • A normal anion gap is 12 +/- 4.
    • An increased anion gap is often associated with metabolic acidosis.

    Examples of Increased Anion Gap Metabolic Acidosis

    • Renal failure
    • Diabetic ketoacidosis
    • Lactic acidosis
    • Organic acidemia

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    Description

    Explore the key concepts of acid-base disturbances and their effects on the body's pH levels. This quiz covers the definitions of acidemia and alkalemia, the calculation of hydrogen ion concentration, and the types of disturbances: respiratory and metabolic. Test your understanding of how these imbalances occur and their implications.

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