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?

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

    Which condition may influence acid-base derangements?

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

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

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

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

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

    How does potassium imbalance affect acid-base balance?

    <p>It may induce acid-base imbalances.</p> Signup and view all the answers

    What does Base Excess indicate in relation to pH?

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

    Which condition is NOT commonly associated with metabolic acidosis?

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

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

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

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

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

    How does the body respond to a base deficit?

    <p>Increases renal acid secretion</p> Signup and view all the answers

    Which statement correctly describes a result of severe metabolic acidosis?

    <p>More negative Base Excess indicating worse acidosis</p> Signup and view all the answers

    What does a pH below 7.35 indicate?

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

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

    <p>Immediate response of protein buffering system</p> Signup and view all the answers

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

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

    What is a typical treatment approach for Metabolic Acidosis?

    <p>High flow oxygen</p> Signup and view all the answers

    Which condition is NOT a common cause of Metabolic Alkalosis?

    <p>Renal Failure</p> Signup and view all the answers

    How does high altitude acclimation contribute to Respiratory Alkalosis?

    <p>By inducing hypocapnia</p> Signup and view all the answers

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

    <p>H2O + CO2</p> Signup and view all the answers

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

    <p>Administering Bicarbonate</p> Signup and view all the answers

    What is a typical sign of Respiratory Acidosis?

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

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

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

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

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

    Which assessment finding might indicate Metabolic Alkalosis?

    <p>Nausea and vomiting</p> Signup and view all the answers

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

    <p>Bicarbonate transport in plasma</p> Signup and view all the answers

    Which type of buffering is primarily involved during respiratory distress?

    <p>Carbonic acid-bicarbonate buffering</p> Signup and view all the answers

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

    <p>Increase in hydrogen ions in the blood</p> Signup and view all the answers

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

    <p>Severe hemorrhaging</p> Signup and view all the answers

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

    <p>Slow chronic metabolic acidosis</p> Signup and view all the answers

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

    <p>End-tidal capnography</p> Signup and view all the answers

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

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

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

    <p>They excrete bicarbonate in urine when needed.</p> Signup and view all the answers

    What is the primary underlying cause of respiratory alkalosis?

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

    Which treatment is indicated for managing metabolic acidosis?

    <p>Sodium Bicarbonate IV infusion</p> Signup and view all the answers

    In which condition would you expect elevated PaCO2 levels?

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

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

    <p>Carpal pedal spasms</p> Signup and view all the answers

    What is a significant treatment focus in addressing metabolic alkalosis?

    <p>Identifying the underlying cause</p> Signup and view all the answers

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

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

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

    <p>Disturbances in heart rhythm</p> Signup and view all the answers

    Which condition would most likely result in metabolic alkalosis?

    <p>Persistent vomiting</p> Signup and view all the answers

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

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

    Which finding suggests a mixed acid-base disorder?

    <p>Elevated PaCO2 with elevated HCO3-</p> Signup and view all the answers

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

    <p>Administer high flow oxygen</p> Signup and view all the answers

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

    <p>Sepsis and hypoxia</p> Signup and view all the answers

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

    <p>Increased pCO2 with normal or slightly increased HCO3-</p> Signup and view all the answers

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

    <p>Renal excretion of hydrogen ions</p> Signup and view all the answers

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

    <p>Hyperventilation leading to decreased pCO2 levels</p> Signup and view all the answers

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

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

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

    <p>HCO3- levels above 26</p> Signup and view all the answers

    Which treatment protocol is essential for managing significant metabolic acidosis?

    <p>Administering bicarbonate directly to correct pH levels</p> 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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