Podcast
Questions and Answers
How does the body primarily maintain acid-base balance?
How does the body primarily maintain acid-base balance?
- Through respiratory and renal regulation of hydrogen ions and bicarbonate. (correct)
- By altering the rate of glucose metabolism to produce more or less CO2.
- By releasing hormones that neutralize acids and bases in the bloodstream.
- By directly controlling electrolyte absorption in the intestines.
Using the Henderson-Hasselbalch equation, if a patient's bicarbonate ([HCO3-]) level is 24 mEq/L and their pCO2 is 40 mmHg, what would be their approximate pH?
Using the Henderson-Hasselbalch equation, if a patient's bicarbonate ([HCO3-]) level is 24 mEq/L and their pCO2 is 40 mmHg, what would be their approximate pH?
- 7.20
- 7.80
- 7.40 (correct)
- 7.60
In the context of acid-base balance, what is the role of the lungs?
In the context of acid-base balance, what is the role of the lungs?
- To directly regulate the concentration of bicarbonate ions in the blood.
- To excrete excess acids and bases into the urine.
- To produce buffers that neutralize strong acids.
- To control the level of carbonic acid in the blood by regulating CO2 exhalation. (correct)
What is the primary role of the kidneys in maintaining acid-base balance?
What is the primary role of the kidneys in maintaining acid-base balance?
Which of the following best describes how the respiratory system compensates for metabolic acidosis?
Which of the following best describes how the respiratory system compensates for metabolic acidosis?
A patient presents with rapid, shallow respirations. How would this affect their PaCO2 levels and overall pH?
A patient presents with rapid, shallow respirations. How would this affect their PaCO2 levels and overall pH?
What characterizes metabolic acidosis in terms of serum bicarbonate levels and arterial pH?
What characterizes metabolic acidosis in terms of serum bicarbonate levels and arterial pH?
In the context of acid-base balance, what does the term 'anion gap' refer to?
In the context of acid-base balance, what does the term 'anion gap' refer to?
What is the formula to calculate the anion gap?
What is the formula to calculate the anion gap?
How does an increased anion gap generally correlate with the clinical state of a patient?
How does an increased anion gap generally correlate with the clinical state of a patient?
Which of the following conditions is most likely to cause a non-anion gap metabolic acidosis?
Which of the following conditions is most likely to cause a non-anion gap metabolic acidosis?
What condition is indicated by a serum pH greater than 7.45 and bicarbonate levels greater than 26 mEq/L?
What condition is indicated by a serum pH greater than 7.45 and bicarbonate levels greater than 26 mEq/L?
Which clinical scenario is most likely to result in metabolic alkalosis?
Which clinical scenario is most likely to result in metabolic alkalosis?
How does hypoventilation lead to respiratory acidosis?
How does hypoventilation lead to respiratory acidosis?
What condition describes excess CO2 in the blood?
What condition describes excess CO2 in the blood?
Which condition is commonly associated with hyperventilation?
Which condition is commonly associated with hyperventilation?
What is the primary characteristic of a mixed acid-base disorder?
What is the primary characteristic of a mixed acid-base disorder?
In the context of acid-base balance, what does 'compensation' generally refer to?
In the context of acid-base balance, what does 'compensation' generally refer to?
Which condition typically requires immediate treatment to maintain electrolyte balance?
Which condition typically requires immediate treatment to maintain electrolyte balance?
What is the normal number of parts of bicarbonate to carbonic acid in the body?
What is the normal number of parts of bicarbonate to carbonic acid in the body?
Flashcards
Henderson-Hasselbalch Equation
Henderson-Hasselbalch Equation
A formula to calculate pH based on bicarbonate and partial pressure of carbon dioxide.
Normal blood pH
Normal blood pH
Normal range: 7.35-7.45. Measures the acidity or alkalinity of the blood.
Normal pCO2 range
Normal pCO2 range
Normal range: 35-45 mm Hg. Measures the partial pressure of carbon dioxide in the blood, indicating respiratory function.
Normal HCO3 range
Normal HCO3 range
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Kidney's role in HCO3 regulation
Kidney's role in HCO3 regulation
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Effect of breathing on PCO2
Effect of breathing on PCO2
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What is hyperventilation?
What is hyperventilation?
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What is hypoventilation?
What is hypoventilation?
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Metabolic acidosis
Metabolic acidosis
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Anion Gap
Anion Gap
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High Anion Gap Acidosis
High Anion Gap Acidosis
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Non-Anion Gap Metabolic Acidosis
Non-Anion Gap Metabolic Acidosis
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Metabolic Alkalosis
Metabolic Alkalosis
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Respiratory Acidosis
Respiratory Acidosis
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Respiratory Alkalosis
Respiratory Alkalosis
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Mixed Acid-Base Disorder
Mixed Acid-Base Disorder
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Study Notes
- Chapter focuses on acids and bases in the body
How the Body Handles H+ and HCO3
- Henderson-Hasselbalch equation is used to understand how the body handles H+ and HCO3
- pH = 6.1 + log10([HCO3-] / (0.03 x pCO2))
- The equation H + HCO3 ↔ H2CO3 ↔ CO2 + H2O shows the relationship between hydrogen ions, bicarbonate, carbonic acid, carbon dioxide, and water
Normal Values
- Normal pH is 7.35-7.45 (7.4)
- Normal pCO2 is 35-45 (40)
- Normal HCO3 is 22-26 (24)
HCO3 vs PCO2
- HCO3 is a base regulated by the kidneys: HCO3 is made in and removed from the kidney
- HCO3 changes occur over longer periods such as days and relate to multiple or metabolic disorders
- PCO2 is an acid regulated by the lungs; changes occur immediately such as minutes
- Changes in PCO2 relate to single or respiratory disorders and are affected by breathing rate
Respiratory Regulation
- Hyperventilation leads to a decrease in PaCO2 and a decrease in H+
- Hypoventilation leads to an increase in PaCO2 and an increase in H+
Renal Regulation
- The kidneys regulate acid-base balance.
- Kidneys excrete either acidic or basic urine
- Kidneys regulate acid-base through excretion and regeneration of HCO3- along with excretion of H+
Metabolic Acidosis
- Hallmark sign of metabolic acidosis: low serum bicarbonate (HCO3)
- Arterial pH measures below 7.35
- Loss of Bicarb (no anion gap)
- HCO3 decreases and Chloride increases
- Too much Acid (anion gap)
- Bicarb combines with H+
Anion Gap
- Normal anion gap is 12
- Calculated as (Na+) - (HCO3 + Cl-)
- Example: 140 - (24 + 104) = 12
- A higher anion gap indicates a more acute clinical situation
More on Metabolic Acidosis
- Anion Gap Metabolic Acidosis Causes
- M- Methanol
- U- Uremia
- D- DKA
- P- Paraldehyde
- I- Iron; INH
- L- Lactic Acidosis
- E- Ethylene Glycol
- S- Salicylates
- Non-anion Gap Metabolic Acidosis Causes
- Diarrhea
- Renal tubular acidosis
- Carbonic Anhydrase inhibitors like Acetazolamide
- Treatment: Fluid administration, address underlying cause
Metabolic Alkalosis
- Serum pH measures above 7.45
- Bicarb levels measure over 26 mEq/L.
- Occurs when HCO3- is increased
- This is due to either a loss of acid or accumulation of base
- Example of a loss of acid: vomiting, gastric suctioning, diuretics, hypokalemia
- Example of accumulation of base: administration of Bicarb
Respiratory Acidosis
- Respiratory acidosis is caused by a decrease in the rate of breathing (alveolar hypoventilation)
- CO2 is retained, leading to CO2 excess, which is also called hypercapnia
- May be acute or chronic; chronic cases include COPD where renal compensation occurs over days
- Common causes of respiratory acidosis are over-sedation and head injury
Respiratory Alkalosis
- Respiratory alkalosis involves alveolar hyperventilation, leading to decreased CO2 and hypocapnia
- Stimulated by increased breathing
- Example stimulants are fever, anemia, anxiety/panic disorder, mechanical ventilation, and pain.
Mixed Acid-Base Disorders
- Mixed acid-base disorders involve two primary disorders occurring simultaneously
- Most common in hospital patients and patients in the ICU
Compensation
- Body compensates by using respiratory or metabolic processes:
- Respiratory Acidosis is compensated for via metabolic processes
- Respiratory Alkalosis is compensated for via metabolic processes
- Metabolic Acidosis is compensated for via respiratory processes
- Metabolic Alkalosis is compensated for via respiratory processes
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