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Final Exam
Blood Gas Management and Blood pH
50
Chemistry
Graduate
04/16/2013

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Term
gas
Definition
collection of molecules which move about freely
Term
ideal gas model
Definition
model of matter in which the molecules are treated as non-interacting point particles which are engaged in a random motion that obeys conservation of energy.
Term
standard temperature and pressure
Definition
22.4 liters of most gases at standard temperature and pressure will contain very nearly 6.022 × 10^23 molecules (one mole).
Term
gas laws
Definition
empirical laws that describe the relationship between thermodynamic temperature, absolute pressure and volume of gases.
Term
Boyle's law
Definition
inversely proportional relationship between the absolute pressure and volume of a gas, if the temperature is kept constant within a closed system.
Term
Charle's law
Definition
proportional relationship between temperature and the volume of a gas at constant pressure
Term
Dalton's law
Definition
the total pressure exerted by a gaseous mixture is equal to the sum of the partial pressures of each individual component in a gas mixture.
Term
Henry’s Law
Definition
At a constant temperature, the amount of a given gas dissolved in a given type and volume of liquid is directly proportional to the partial pressure of that gas in equilibrium with that liquid.
Term
Methemoglobin
Definition
Normal hemoglobin can have its Fe2+ oxidized to Fe3+ by a variety of drugs and chemicals including nitrites, sulfonamides, acetanilide
Term
methemoglobin reductase
Definition
responsible for converting methemoglobin back to hemoglobin A
Term
Normal percentage of methemoglobin
Definition
1-2%
Term
O2 Capacity
Definition
The maximum amount of O2 which can be combined with hemoglobin
Term
Oxygen saturation
Definition
measures the percentage of hemoglobin binding sites in the bloodstream occupied by oxygen
Term
O2 Saturation of Hemoglobin equation
Definition
(O2 combined with Hb/O2 capacity) x 100
Term
The oxygen dissociation curve
Definition
plots the proportion of hemoglobin in its saturated form on the vertical axis against the prevailing oxygen tension on the horizontal axis.
Term
Bohr Effect
Definition
Changes associated with pCO2
Term
Haldane effect
Definition
Deoxygenation of the blood increases its ability to carry carbon dioxide
Term
Right shift
Definition
increase in temperature, 2,3-DPG, pCO2, and decrease in pCO, pH
Term
Left Shift
Definition
increase in pCO, and pH decrease in temperature, 2,3-DPG, and pCO2
Term
P50
Definition
The partial pressure of oxygen (pO2)at which the hemoglobin is 50% saturated, typically about 27 mmHg for a healthy person
Term
increased P50
Definition
rightward shift of the standard curve
Term
decreased p50
Definition
Left shift
Term
What is responsible for elimination of CO2
Definition
alveolar ventilation
Term
In acid-base balance, the kidney is responsible for 2 major activities
Definition
Reabsorption of filtered bicarbonate:
Excretion of the fixed acids
Term
Henderson-Hasselbalch Equation
Definition
pH =pKa + log (A-/HA)
Term
Acidosis
Definition
an abnormal process or condition which would lower arterial pH if there were no secondary change in response to the primary etiological factor
Term
Alkalosis
Definition
an abnormal process or condition which would raise arterial pH if there were no secondary changes in response to the primary etiological factor
Term
Simple (Acid-Base) disorders
Definition
are those in which there is a single primary etiological acid-base disorder
Term
Mixed (Acid-Base) disorders
Definition
are those in which two or more primary etiological disorders are present simultaneously
Term
Acidemia
Definition
arterial pH < 7.36
Term
Alkalaemia
Definition
arterial pH > 7.44
Term
Metabolic Acidosis etiology
Definition
uncontrolled diabetes (accumulation of ketoacids), lactic acid accumulation (exercise, poor perfusion, systemic infections), renal tubular acidosis (kidnets can't execute H+/Na+ exchange), liver disease (impaired urea/ammonia formation), salicylate intoxication (hyperventiliation, loss of bicarbonate), poisonings (converted to acid), or ingestion of carbonic anhydrase inhibitors
Term
Metabolic Acidosis Compensation methods
Definition
retention of HCO3, hyperventilation, or kidnye excretes organic acids and exchanges H+ for Na+, more acid urine
Term
Metabolic Acidosis Laboratory findings
Definition
Decreased pH
Decreased HCO3
Initial pCO2 normal but will become decreased as compensating mechanisms are invoked
Negative base excess
In lactic acidosis there may be ↑anion gap, ↑K+, ↑lactate,
Poisoning, i.e., drugs, methanol etc. there may be ↑anion gap
Term
Respiratory Acidosis
Definition
Based deficit disorder resulting from a decreased HCO3/H2CO3 ratio resulting from an increase in carbonic acid
Term
Respiratory Acidosis etiology
Definition
disorders that interfere with the ability of the lungs to expel CO2: COPD, depression of the respiratory centers (drugs), respiratory distress syndrome (premies or adults in shock)
Term
Respiratory Acidosis Compensation methods
Definition
hyperventilation to eliminate CO2, retain Na+ and HCO3 with increased acid excretion
Term
Respiratory Acidosis Laboratory findings
Definition
Decreased pH
Increased pCO2
Initially a normal HCO3 which becomes increased as compensatory mechanisms are employed
Normal base excess
Coexisting metabolic lactic acidosis may exist due to tissue hypoxia
Term
Metabolic Alkalosis
Definition
base excess, high pH, increase in bicarb with no change in carbonic acid
Term
Metabolic Alkalosis Etiology
Definition
increased concentration of HCO3: Excessive intake of NaHCO3 (gastric disease, tums), loss of chloride (vomiting)
Term
Respiratory Alkalosis
Definition
Disorder associated with a decrease in carbonic acid concentration usually resulting from over stimulation of the respiratory system.
Term
Respiratory Alkalosis Etiology
Definition
hyperventilation, salicylate intoxification, impairment of CNS, aggressive mechanical ventilation
Term
Respiratory Alkalosis Compensation methods
Definition
increased excretion of bicarbonate, slow respiration
Term
Respiratory Alkalosis laboratory findings
Definition
Increased HCO3/H2CO3 ratio
Increased pH
Initially a decreased pCO2 but may increase as compensation is initiated
Initially normal with decreased concentrations as renal compensation is initiated
Decreased base excess
Alkaline urine with titratable HCO3
Term
6 steps of systemic acid-base evaluation
Definition
(1) pH (2) pattern (3) clues (4) compensation (5) formulation (6) confirmation
Term
pH in evaluation of acid-base disorder
Definition
arterial pH, acidaemia = acidosis, alkalaemia = alkalosis, normal = no disorder or compensation
Term
pattern in evaluation of acid-base disorder
Definition
suggestive pattern in pCO2 and [HCO3, if both are low = metabolic acidosis or respiratory alkalosis, if both are high = metabolic alkalosis or respiratory acidosis, if they are opposite = mixed disorder
Term
clues in evaluation of acid-base disorder
Definition
high anion gap = metabolic acidosis, hyperglycaemia = diabetic ketoacidosis, hypokalaemia/chloraemia = metabolic alkalosis
Term
compensation in evaluation of acid-base disorder
Definition
if expectal and actual match = not mixed
if they don't match = mixed
Term
formulation in evaluation of acid-base disorder
Definition
consider everything together
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