Lecture 27 Blood Gases and Acid-Base Balance

An acid can ___ a hydrogen ion.

A base can ___ a hydrogen ion.

A ___ acid completely dissociates into a H+ and its conjugate base. These usually have ____ conjugate bases.

A ____ acid only slighly dissociates in aqueous solution. These usually have ___ conjugate bases. 

A ____ is a mixture of substances that can resist changes in H+ concnetration when strong bases/acids are added. These are usually a ___ acid and its conjugate base. 

donate; accept; strong; weak; weak; strong; buffer; weak

pH = -log[H+]

A value below 7.35 is called ____

A value above 7.45 is called ____

The ____ concentration varies at various pH.

The metabolism of glucose and fat procuded ____ acids or carbonic acids which is eliminated by the ____.

The metabolism of proteins and anerobic metabolism produces ____, sulfuric, and phophoric acids  which are ____ acids and are eliminated by the _____. 

acidosis; alkalosis; hydrogen; voltaile; lungs; lactic; fixed; kidneys 

The normal range for pH is ____ to 7.45.

The pH is regulated by:

1. The chemical ____ systems.

2. The ____ which elimiate CO2

3. The ____ which eliminate H+ and reabsorb/generate bicarbonate.

The body mainly relies on the __ to get rid of acid.

The isohydric principle states all buffer pairs in a homogenous solution are in ____ with the same H+ concentration.

7.35; buffer; lungs; kidneys; lungs; equilibrium

The ____ tells you the strength of an acid/base. If the pKa = pH, there is an equal concentration of acid and its conjugate ____.

The normal range for bicarb is ____ to 28.

pKa; base; 22

Respiratory disorders involve an alteration in _____ which reflects an inc/dec in alveolar ____.

If a patient has increased PCO2 levels, the patient has respiratory _____. This means there is ____ carbonic acid and a low pH. The compensatory method includes increasing bicarb ______ in the kidneys.

If the patient has decreased PCO2 levels, the patient has respiratory ____ and thus ____ carbonic acid and a high pH. The kidneys will respond by ____ bicarb reabsorption.

PaCO2; ventilation; acidosis; increased; reabsorption; alkalosis; decreased; decreasing

Common causes of respiratory acidosis include:

1. ____ of the respiratory control centers 

2. _____ disorders like a SCI and phrenic nerve injury.

3. Chest wall _____

4. ____ restriction like pulmonary fibrosis 

5. Pulmonary parenchymal diseases like pneumonia and pulmonary ____. 

6. An airway _____ that prevents exhalation.

depression; neuromuscular; restriction; lung; edema; obstruction

Common causes of respiratory alkalosis include:

1. Issues w the ____ nervous system like anxiety, hyperventilation, etc.

2. ____ or hormones

3. Pulmonary diseases like ___ and pulmonary embolism

4. Bacteremia and fever

5. Overventilation with _____ ventilators

6. Hypoxia and ___ altitude.

central; drugs; asthma; mechanical; high

Metabolic disorders produce an alterations in the serum _______ and results from the addition/loss of nonvolatile ____or alkali.

A person with increased H+ will have a ____ pH and will have metabolic ______. They will also have _____ bicarb. To compensate, the patient will exhibit _____ or deeper breathing.

A person with decreased H+ will have a ___ pH and will have metabolic _____. They will have ____ bicarb. To compensate, the patient will exhibit ____ and shallower breathing.

bicarbonate; acid; low; acidosis; decreased; heavier; high; alkalosis; increased; lighter

The base excess is a measurement used the excess or deficiency of _____. It is the amount of acid/base needed to titrate a liter of ___ to a pH of 7.4.

The ____ gap is a measure of the unmeasured acids in the blood. It is important in determining the cause of ____ _____.

The normal range for this gap is ____ ± 4.

If the gap is greater than 16, that means there is excess ___ which can come from lactic acidosis, diabetic _____, or organic ions. It can also come from renal _____ of sulfate, phosphate, and urate or decreased K, Ca, or Mg

If the gap is normal, it means bicarb is being used up but the _____ ion is replacing it.

bicarbonate; blood; anion; metabolic acidosis; 12; acids; ketoacidosis; retention; chloride

Common causes of metabolic acidosis include:

1. Ingested ___ or toxic substances like alcohol and methanol. This will lead to an ____ anion gap. 

2. The loss of bicarb ions through ____ and pancreatic fistulas. This leads to a ___ anion gap. 

3. The inability to ____ H+ which occurs in renal dysfunction. This leads to a ____ anion gap. 

4. Lactic ____ through hypoxemia, ARDS, anemia, shock. This leads to an ____ anion gap. 

5. ______ which occurs from diabetes mellitus, alcoholism, and starvation. This leads to an ____ anion gap. 

drugs; increased; diarrhea; normal; excrete; increased; acidosis; increased; ketoacidosis; increased

Common causes metabolic alkalosis includes:

1. Loss of hydrogen ions via ____, diuretic therapy, and treatments with mineralcorticoids like ____

2. Ingestion or ____ of excess bicarb or base.

vomiting; aldosterone; administering

Metabolic acidosis leads to ____ alveolar ventilation

Metabolic alkalosis leads to _____ alveolar ventilation

The respiratory compensatory mechanism operates very ____ (within minutes) to ______ correct metabolic acidosis or alkalosis.

increased; decreased; rapidly; partially 

Renal mechanisms in acidosis include excreting _____ acids and ____ filtered bicarbonate.

Renal mechanisms in alkalosis include decreasing ____ ion excretion and ___ the retention of filtered bicarb.

These mechanisms work much more ____ than respiratory mechanisms like 3-6 days.

fixed; retaining; hydrogen; decreasing; slowly