Biochemistry

Question 1

what is being controlled in the blood?

Answer 1

H+ concentration

Question 2

four buffers in the blood

Answer 2

• H+ + HCO3- > H2CO3 > CO2 + H2O
• H+ + Hb- > HHb
• H+ + HPO42- > H2PO4-
• H+ + NH3 > NH4+

Question 3

what is the respiratory component

Answer 3

pCO2

Question 4

what is the metabolic component

Answer 4

HCO3-

Question 5

respiratory acidosis

Answer 5

increase in [H+], due to increased pCO2

Question 6

respiratory alkalosis

Answer 6

decrease in [H+], due to decreased pCO2

Question 7

metabolic acidosis

Answer 7

increase in [H+], due to decreased HCO3-

Question 8

metabolic alkalosis

Answer 8

decrease in [H+], due to increased HCO3-

Question 9

compensation for excess H+/HCO3-

Answer 9

lungs blow off CO2

Question 10

compensation for excess CO2

Answer 10

kidneys remove H+

Question 11

causes of respiratory acidosis

Answer 11

choking
bronchopneumonia
COAD

Question 12

causes of respiratory alkalosis

Answer 12

hyperventilation

raised intracranial pressure

Question 13

causes of metabolic acidosis

Answer 13

impaired H+ secretion
increased H+ production
loss of HCO3-

Question 14

causes of metabolic alkalosis

Answer 14

loss of H+ in vomit
alkali ingestion
potassium deficiency

Question 15

what does a normal pCO2 in a hypoxic asthmatic patient indicate?

Answer 15

they are tiring and need ITU intervention

Question 16

6 stages in approaching an ABG

Answer 16

1. hypoxic >10kPa
2. respiratory failure?
3. pH (acidotic is <7.35 or alkalic >7.45)
4. pCO2
5. HCO3-
6. compensation?

Question 17

type 1 respiratory failure ABG

Answer 17

pO2 <8kPa (V/Q mismatch)

Question 18

type 2 respiratory failure ABG

Answer 18

pO2 <8kPa and pCO2 >6kPa (inability to remove CO2)