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Patho Acid Base
35問 • 2年前
  • Two Clean Queens
    • 通報

    問題一覧

  • 1

    Acid Sources

    Carbonic acid (H2CO3), Lactic Acid, Sulfuric Acid, Phosphoric Acid, Ketone Bodies

  • 2

    Buffer Systems

    Plasma (bicarb-carbonic acid, Hbg), Intracellular (protein, phosphate), Kidneys (bicarb, ammonia, phosphate), Lungs (CO2)

  • 3

    Buffer systems help absorb

    H+ or OH- (hydrogen ions or hydroxide ions)

  • 4

    Left side of equation

    Lungs: Gain H+—> shift to left—> lungs increase ventilation to expel CO2

  • 5

    Right side of equation

    Kidneys: Lose H+—> shift to right—> lungs retain more CO2

  • 6

    First line of defense against alternations in acid base

    Bicarbonate

  • 7

    Negative charge, buffers H+, binds to Ca, changes amount of free Ca based in acid base

    Albumin

  • 8

    Add H2O—>H2CO3–>Carries carbonic acid (H2CO3)—>dissociated—> Hbg buffers H+. In lungs, process reverses and CO2 expired

    Hbg

  • 9

    Buffer that increases amount of Ca in the blood

    Albumin

  • 10

    Inorganic Phosphates

    HPO4-2/H2PO4 - Buffer

  • 11

    Organic Phosphates

    ATP, ADP, AMP, glucose-1-phosphate, and 2,3-DPG (diphosphoglycerate)

  • 12

    If Chemical Buffers cannot keep up this kicks in

    Lungs

  • 13

    If Lungs cannot keep up this kicks in

    Kidneys

  • 14

    How the lungs compensate

    Change minute ventilation

  • 15

    Kidneys regulate extracellular fluid H+ in 3 ways:

    1. Secrete H+ for removal in urine 2. Reabsorption of filtered bicarbonate ions 3. Production of new bicarbonate ions

  • 16

    Reabsorption of bicarbonate ions

    Combine excess H+ in tubules with phosphates and ammonia to excrete bicarbonate that is then reabsorbed

  • 17

    Bicarbonate production and reabsorption must slow down, thus H+ secretion decreases and phosphorus and ammonia not excreted

    Alkalosis

  • 18

    Increased CO2 increase H+ production—> H+ is secreted in tubule fluid and combines with CO2 and H2O and/or NH3 or NaHPO4–> bicarbonate that is reabsorbed as buffer

    Acidosis

  • 19

    Acid Base Labs

    Serum CO2, ABG (most accurate), Base excess/deficit, O2 Saturation

  • 20

    Reduction in serum bicarbonate. Increase acid production: lactic acidosis, ketoacidosis, ingestion; Loss of bicarbonate: GI losses, kidney losses, elevated aldosterone; Diminished renal acid secretion

    Metabolic Acidosis

  • 21

    Manifestations: Decreased myocardial contractility, decreased CO, Catecholamine resistant hypotension, Hyperkalemia and ventricular arrhythmias

    Metabolic Acidosis

  • 22

    Anion Gap Normal

    6-12

  • 23

    Gap Acidosis

    >12

  • 24

    Non-Gap Acidosis

    </= 12

  • 25

    Gap Acidosis Manifestations

    MUDPILES: Methanol, Uremia, DKA, Paraldehyde/phenformin/propofol, Iron/INH, Lactic acidosis, Ethylene glycol, Salicylates

  • 26

    Non-Gap Acidosis Manifestations

    Kidney losses, GI losses, Volume overload, Hypernatremia (fluid restriction), Kidney failure

  • 27

    Excess bicarbonate or deficiency of H+. Excess bicarbonate and inability to excrete excess bicarbonate from kidneys. Causes: Emesis (Hydrochloric Acid loss) and Diuretic use.

    Metabolic Alkalosis

  • 28

    Manifestations: Hypokalemia (ATach, PVCs), muscle cramps and weakness); Hypocalcemia (Paresthesia); Hypoventilation

    Metabolic Alkalosis

  • 29

    Excess PaCO2. Causes: Airway obstruction, PNA, Pulmonary Edema, ARDS, COPD, Brain stem injury, Oversedation, Spinal muscle atrophy, Guillain Barre

    Respiratory Acidosis

  • 30

    Manifestations: H/A, Blurred vision, Muscle cramps, Disorientation, Restlessness, Seizures, Respiratory rate initially increased then decreased

    Respiratory Acidosis

  • 31

    Deficiency of PaCO2 - Blow off too much CO2. Causes: Hypoxemia, Hypermetabolism (fever, anemia, hyperthyroidism), Neuro (panic disorders, head injury)

    Respiratory Alkalosis

  • 32

    Manifestations: Tachypnea, Dizziness, Confusion, Seizures, Decreased Ca (Paresthesia)

    Respiratory Alkalosis

  • 33

    Acid-Base Reaction Enzyme

    Carbonic Anhydrase

  • 34

    In alkalosis, albumin

    Binds more Ca+

  • 35

    Serum CO2 will:

    Increase in Alkalosis and Decrease in Acidosis

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    問題一覧

  • 1

    Acid Sources

    Carbonic acid (H2CO3), Lactic Acid, Sulfuric Acid, Phosphoric Acid, Ketone Bodies

  • 2

    Buffer Systems

    Plasma (bicarb-carbonic acid, Hbg), Intracellular (protein, phosphate), Kidneys (bicarb, ammonia, phosphate), Lungs (CO2)

  • 3

    Buffer systems help absorb

    H+ or OH- (hydrogen ions or hydroxide ions)

  • 4

    Left side of equation

    Lungs: Gain H+—> shift to left—> lungs increase ventilation to expel CO2

  • 5

    Right side of equation

    Kidneys: Lose H+—> shift to right—> lungs retain more CO2

  • 6

    First line of defense against alternations in acid base

    Bicarbonate

  • 7

    Negative charge, buffers H+, binds to Ca, changes amount of free Ca based in acid base

    Albumin

  • 8

    Add H2O—>H2CO3–>Carries carbonic acid (H2CO3)—>dissociated—> Hbg buffers H+. In lungs, process reverses and CO2 expired

    Hbg

  • 9

    Buffer that increases amount of Ca in the blood

    Albumin

  • 10

    Inorganic Phosphates

    HPO4-2/H2PO4 - Buffer

  • 11

    Organic Phosphates

    ATP, ADP, AMP, glucose-1-phosphate, and 2,3-DPG (diphosphoglycerate)

  • 12

    If Chemical Buffers cannot keep up this kicks in

    Lungs

  • 13

    If Lungs cannot keep up this kicks in

    Kidneys

  • 14

    How the lungs compensate

    Change minute ventilation

  • 15

    Kidneys regulate extracellular fluid H+ in 3 ways:

    1. Secrete H+ for removal in urine 2. Reabsorption of filtered bicarbonate ions 3. Production of new bicarbonate ions

  • 16

    Reabsorption of bicarbonate ions

    Combine excess H+ in tubules with phosphates and ammonia to excrete bicarbonate that is then reabsorbed

  • 17

    Bicarbonate production and reabsorption must slow down, thus H+ secretion decreases and phosphorus and ammonia not excreted

    Alkalosis

  • 18

    Increased CO2 increase H+ production—> H+ is secreted in tubule fluid and combines with CO2 and H2O and/or NH3 or NaHPO4–> bicarbonate that is reabsorbed as buffer

    Acidosis

  • 19

    Acid Base Labs

    Serum CO2, ABG (most accurate), Base excess/deficit, O2 Saturation

  • 20

    Reduction in serum bicarbonate. Increase acid production: lactic acidosis, ketoacidosis, ingestion; Loss of bicarbonate: GI losses, kidney losses, elevated aldosterone; Diminished renal acid secretion

    Metabolic Acidosis

  • 21

    Manifestations: Decreased myocardial contractility, decreased CO, Catecholamine resistant hypotension, Hyperkalemia and ventricular arrhythmias

    Metabolic Acidosis

  • 22

    Anion Gap Normal

    6-12

  • 23

    Gap Acidosis

    >12

  • 24

    Non-Gap Acidosis

    </= 12

  • 25

    Gap Acidosis Manifestations

    MUDPILES: Methanol, Uremia, DKA, Paraldehyde/phenformin/propofol, Iron/INH, Lactic acidosis, Ethylene glycol, Salicylates

  • 26

    Non-Gap Acidosis Manifestations

    Kidney losses, GI losses, Volume overload, Hypernatremia (fluid restriction), Kidney failure

  • 27

    Excess bicarbonate or deficiency of H+. Excess bicarbonate and inability to excrete excess bicarbonate from kidneys. Causes: Emesis (Hydrochloric Acid loss) and Diuretic use.

    Metabolic Alkalosis

  • 28

    Manifestations: Hypokalemia (ATach, PVCs), muscle cramps and weakness); Hypocalcemia (Paresthesia); Hypoventilation

    Metabolic Alkalosis

  • 29

    Excess PaCO2. Causes: Airway obstruction, PNA, Pulmonary Edema, ARDS, COPD, Brain stem injury, Oversedation, Spinal muscle atrophy, Guillain Barre

    Respiratory Acidosis

  • 30

    Manifestations: H/A, Blurred vision, Muscle cramps, Disorientation, Restlessness, Seizures, Respiratory rate initially increased then decreased

    Respiratory Acidosis

  • 31

    Deficiency of PaCO2 - Blow off too much CO2. Causes: Hypoxemia, Hypermetabolism (fever, anemia, hyperthyroidism), Neuro (panic disorders, head injury)

    Respiratory Alkalosis

  • 32

    Manifestations: Tachypnea, Dizziness, Confusion, Seizures, Decreased Ca (Paresthesia)

    Respiratory Alkalosis

  • 33

    Acid-Base Reaction Enzyme

    Carbonic Anhydrase

  • 34

    In alkalosis, albumin

    Binds more Ca+

  • 35

    Serum CO2 will:

    Increase in Alkalosis and Decrease in Acidosis