Acid Base Lecture Quiz

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Questions and Answers

What is the role of hydrogen ions in the body concerning pH levels?

Hydrogen ions are solely responsible for maintaining blood pressure.

Lower hydrogen concentration corresponds to higher pH levels.

Hydrogen ions contribute to the acidity of bodily fluids. (correct)

Higher hydrogen concentration raises pH levels.

Which substance is produced as a by-product of cellular metabolism that can affect acid-base balance?

Sodium Bicarbonate

Potassium

Oxygen

Carbon Dioxide (correct)

What is the normal pH range for the human body?

6.0 - 6.5

7.35 - 7.45 (correct)

7.0 - 7.5

8.0 - 8.5

What common cause of metabolic acidosis is frequently found in injured patients?

Lactic acidosis Signup and view all the answers

Which condition may influence acid-base derangements?

Dehydration Signup and view all the answers

What differentiates Normal Saline from Ringer's Lactate in terms of pH?

Ringer's Lactate has a higher pH than Normal Saline. Signup and view all the answers

What role does carbonic acid play in the buffer system of the body?

It can dissociate into hydrogen and bicarbonate ions, impacting pH. Signup and view all the answers

How does potassium imbalance affect acid-base balance?

It may induce acid-base imbalances. Signup and view all the answers

What does Base Excess indicate in relation to pH?

The amount of strong acid needed to achieve a pH of 7.40 Signup and view all the answers

Which condition is NOT commonly associated with metabolic acidosis?

Respiratory failure Signup and view all the answers

What is the primary control mechanism for metabolic acid-base balance?

Kidneys Signup and view all the answers

Which of the following symptoms is commonly associated with respiratory acidosis?

Hypoxia Signup and view all the answers

How does the body respond to a base deficit?

Increases renal acid secretion Signup and view all the answers

Which statement correctly describes a result of severe metabolic acidosis?

More negative Base Excess indicating worse acidosis Signup and view all the answers

What does a pH below 7.35 indicate?

Severe acidosis Signup and view all the answers

Which factor typically causes a shift in the body's buffering system during hemorrhagic shock?

Immediate response of protein buffering system Signup and view all the answers

Which of the following symptoms is commonly associated with Respiratory Alkalosis?

Dizziness Signup and view all the answers

What is a typical treatment approach for Metabolic Acidosis?

High flow oxygen Signup and view all the answers

Which condition is NOT a common cause of Metabolic Alkalosis?

Renal Failure Signup and view all the answers

How does high altitude acclimation contribute to Respiratory Alkalosis?

By inducing hypocapnia Signup and view all the answers

What physiological process mirrors the relationship of H+ + HCO3- in acid-base balance?

H2O + CO2 Signup and view all the answers

Which treatment is essential for managing severe cases of Metabolic Acidosis?

Administering Bicarbonate Signup and view all the answers

What is a typical sign of Respiratory Acidosis?

Confusion Signup and view all the answers

Which of the following conditions is characterized by a lower than normal bicarbonate level?

Metabolic Acidosis Signup and view all the answers

What is a common cause of Respiratory Alkalosis due to an emotional state?

Anxiety Signup and view all the answers

Which assessment finding might indicate Metabolic Alkalosis?

Nausea and vomiting Signup and view all the answers

What is the primary mechanism for carbon dioxide transport in the blood?

Bicarbonate transport in plasma Signup and view all the answers

Which type of buffering is primarily involved during respiratory distress?

Carbonic acid-bicarbonate buffering Signup and view all the answers

What physiological change typically occurs in the body during metabolic acidosis?

Increase in hydrogen ions in the blood Signup and view all the answers

Which clinical condition is most closely associated with protein buffering derangements?

Severe hemorrhaging Signup and view all the answers

In which scenario would renal buffering take longer to correct acid-base imbalance?

Slow chronic metabolic acidosis Signup and view all the answers

What is the most suitable device used to monitor CO2 elimination during ventilation?

End-tidal capnography Signup and view all the answers

Which of the following is NOT a common cause of metabolic alkalosis?

Hypoventilation Signup and view all the answers

Which statement correctly describes the roles of kidneys in acid-base balance?

They excrete bicarbonate in urine when needed. Signup and view all the answers

What is the primary underlying cause of respiratory alkalosis?

Hyperventilation Signup and view all the answers

Which treatment is indicated for managing metabolic acidosis?

Sodium Bicarbonate IV infusion Signup and view all the answers

In which condition would you expect elevated PaCO2 levels?

Respiratory acidosis Signup and view all the answers

Which of the following symptoms is commonly associated with respiratory alkalosis?

Carpal pedal spasms Signup and view all the answers

What is a significant treatment focus in addressing metabolic alkalosis?

Identifying the underlying cause Signup and view all the answers

Which type of acidosis is most commonly linked with diabetic ketoacidosis (DKA)?

Metabolic acidosis Signup and view all the answers

What is a potential consequence of untreated metabolic acidosis in critically ill patients?

Disturbances in heart rhythm Signup and view all the answers

Which condition would most likely result in metabolic alkalosis?

Persistent vomiting Signup and view all the answers

What does a Base Excess of -9 indicate in a clinical setting?

Severe metabolic acidosis with high sensitivity for massive transfusion protocol (MTP) Signup and view all the answers

Which finding suggests a mixed acid-base disorder?

Elevated PaCO2 with elevated HCO3- Signup and view all the answers

What is the recommended management for a patient in respiratory arrest due to bronchospasm?

Administer high flow oxygen Signup and view all the answers

Which of the following conditions is most closely associated with an increased likelihood of lactic acidosis?

Sepsis and hypoxia Signup and view all the answers

How does respiratory acidosis primarily manifest in terms of blood gas levels?

Increased pCO2 with normal or slightly increased HCO3- Signup and view all the answers

What is the primary mechanism controlling metabolic acid-base balance in the body?

Renal excretion of hydrogen ions Signup and view all the answers

Which of the following is most likely to be a clinical indication of respiratory alkolosis?

Hyperventilation leading to decreased pCO2 levels Signup and view all the answers

What distinguishes metabolic acidosis from respiratory acidosis in terms of their underlying causes?

Metabolic acidosis is related to the bicarbonate levels; respiratory acidosis is related to carbon dioxide retention Signup and view all the answers

Which of the following laboratory findings would typically indicate metabolic alkalosis?

HCO3- levels above 26 Signup and view all the answers

Which treatment protocol is essential for managing significant metabolic acidosis?

Administering bicarbonate directly to correct pH levels Signup and view all the answers

Study Notes

Passive Airway Management

High fowler's position is used for effective airway management.
Conditions that require aggressive airway treatment include COPD, asthma, overdose, and respiratory diseases.
Intubation is indicated for severe airway obstruction or respiratory failure.
CPAP is utilized typically for conditions like ARDS and PE.
High flow oxygen is crucial for patients experiencing hypoventilation or respiratory arrest.

Acid-Base Balance Overview

pH is regulated by the body’s buffer system; normal range is 7.35 - 7.45.
Higher hydrogen concentration results in lower pH, indicating acidity.
Conditions affecting acid-base balance include diseases, dehydration, shock, and trauma.

Respiratory Alkalosis

Causes include hypoxia, hyperventilation, anemia, anxiety, and sepsis.
Symptoms encompass dyspnea, dizziness, and carpal pedal spasms.
Treatment focuses on managing respiration rates, improving CO2 uptake, and addressing underlying causes.

Metabolic Acidosis

Common causes include severe trauma, sepsis, DKA, and ASA overdose.
Patients exhibit symptoms related to respiratory distress and carbon monoxide exposure.
Treatment may involve high flow oxygen, aggressive airway management, and, in some cases, controversial sodium bicarbonate infusion.

Metabolic Alkalosis

Typically caused by vomiting, antacid overdose, and Cushing's syndrome.
Treatment emphasizes fluid and electrolyte replacement, along with identifying causes.

Mixed Acid-Base Disorders

Acid-base imbalances often coexist in critically ill patients.
Emergency treatment plans may involve rapid evaluation and intervention based on base excess or deficit measurements.

Hydrogen and Potassium Dynamics

Potassium shifts in and out of cells can influence acid-base status.
Notable interactions occur in gastrointestinal systems, highlighting the relationship between potassium imbalances and acid-base disturbances.

Concept of Acidosis in Patients

Illness and injury often lead to measurable acidosis, primarily from lactic acid produced during cellular metabolism.
Understanding metabolic causes, such as hemorrhagic shock or sepsis, is essential for effective management.

Base Excess and Base Deficit

The base excess/deficit calculation refers to how much strong acid must be added to normalize pH.
A negative value indicates acidosis; a positive value suggests alkalosis.

PaO2 and Oxygen Consumption

Normal PaO2 ranges from 90-100 mmHg; deviations may indicate tissue hypoxia or organ dysfunction.
Effective oxygen consumption is critical for overall tissue health and metabolic functions.

Respiratory Acidosis

Characterized by hypoxia, altered level of consciousness, and decreased ventilation.
Treatment includes strategies to increase ventilation and correct underlying diseases.

Renal Buffering

Renal buffering involves the exchange of bicarbonate (HCO3-) at the kidneys and takes hours to days to be effective.
Bicarbonate is crucial for carbon dioxide (CO2) transport in blood, accounting for 65%.
Maintains acid-base balance by regulating H+ and HCO3- levels at the nephron tubules.
Bicarbonate is eliminated via urine.

Carbonic Acid-Bicarbonate Buffering

This buffering system primarily occurs in the lungs.
Functions as a compensatory mechanism in acid-base balance.
Closely linked with renal and protein buffering mechanisms.
CO2 levels, monitored through PaCO2 or ETCO2 readings, indicate the effectiveness of this buffering.

CO2 Elimination

H+ and CO2 diffuse to the alveoli in lung capillaries for elimination.
Carbonic acid (H2CO3) quickly dissociates into water (H2O) and carbon dioxide (CO2), which is then exhaled.

Waveform Capnography

End-tidal capnography represents the graphical measurement of CO2 partial pressure during expiration.
Essential for monitoring CO2 elimination in paramedic settings.

Protein Buffering

Requires hemoglobin and circulating blood to eliminate H+ and CO2.
Hemoglobin binding is the primary method for acid elimination.
Reduced effectiveness of protein buffering is often seen in conditions like hemorrhaging.

Acid-Base Disorders

Respiratory and metabolic acidosis or alkalosis can be identified by evaluating bicarbonate (HCO3-) and CO2 (PaCO2) levels.

Respiratory Alkalosis

Characterized by hyperventilation, hypoxia, anxiety, or conditions like sepsis.
Treatment focuses on decreasing respiratory rates and managing underlying causes.

Metabolic Acidosis

Causes include severe trauma, sepsis, diabetic ketoacidosis (DKA), and carbon monoxide exposure.
Management may involve fluid replacement and sodium bicarbonate administration, though the latter is controversial.

Metabolic Alkalosis

Results from vomiting, antacid overdose, or hormonal imbalances like Cushing's syndrome.
Treatment emphasizes fluid and electrolyte replacement.

Complete Acidosis

A state where pH falls below 7.35, indicating severe acidemia, potentially leading to death.

Base Excess / Base Deficit

Measurement of the strong acid needed to achieve a normal pH (7.40) at specified conditions.
Key indicator for metabolic adjustments and related to conditions such as trauma and hemorrhaging.

Acid-Base Balance

Controlled by kidneys (metabolic component - HCO3-) and lungs (respiratory component - PaCO2).
Arterial blood gas (ABG) analysis is used to determine acid-base status.

Respiratory Acidosis

Causes include hypoxia, altered loss of consciousness (ALOC), and cardiac arrest.
Treatment strategies involve improving ventilation and addressing the underlying issues.

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