Exam 4 Chemistry Review/Study Questions Part 5

What are the causes of Metabolic Acidosis?
Diabetic ketoacidosis or starvation
Renal tubular acidosis
Diarrhea (loss of HCO3)
Lactic acid production (tissue hypoxia)
What are the compensation methods for Metabolic Acidosis?
Hyperventilation to blow off excess CO2
Renal excretion of H+ or retention of HCO3 (if kidney disease is not the cause)
What are the causes of Metabolic Alkalosis?
Excessive antacids
Vomiting (loss of HCl)
Diuretics (loss of K and H)
Alkaline Tide following heavy meals
What are the compensation methods for Metabolic Alkalosis?
Hypoventilation to retain CO2
What are the causes of Respiratory Acidosis?
Emphysema
COPD or strangulation
Pneumonia
Morphine or barbiturates (especially with alcohol)which suppress breathing
What are the compensation methods for Respiratory Acidosis?
Kidneys increase excretion of H and retention of HCO3
What are the causes of Respiratory Alkalosis?
Chemical stimulants
Fever or an increased environmental temp
Hysteria, anxiety, prolonged
crying
What are the compensation methods for Respiratory Alkalosis?
Kidneys excrete HCO3 and retain H
Salicylate Poisoning: Initial ______, then ______
Metabolic Acidosis
Respiratory Alkalosis
Strangulation or Alco OD: Initial ______ leading to ______
Respiratory Acidosis
Metabolic Acidosis
DKA with vomiting: ______ plus ______
Metabolic acidosis
Metabolic alkalosis
Hyperventilation is the compensation mechanism for what Acid-Base disorder?
Metabolic Acidosis
Hypoventilation is the compensation mechanism for what Acid-Base disorder?
Metabolic Alkalosis
Retention of HCO3, Secretion of H, is the compensation mechanism for what Acid-Base disorder?
Respiratory Acidosis
Retention of H, Secretion of HCO3, is the compensation mechanism for what Acid-Base disorder?
Respiratory Alkalosis
Total O2 content is the sum of what?
Oxygen bound to Hgb Plus the amount dissolved in the plasma (pO2)
Which of the following is not part of the Venous blood when doing a complete blood gas assessment:
pH, pO2, pCO2, CO2 (HCO3), Lactate, Electrolytes
pH, pO2, pCO2
Which of the following is not part of the Arterial blood sample when doing a complete blood gas assessment:
pH, pO2, pCO2, CO2 (HCO3), Lactate, Electrolytes
CO2 (HCO3), Lactate, Electrolytes
Which of the following is part of the Arterial blood sample when doing a complete blood gas assessment:
pH, pO2, pCO2, CO2 (HCO3), Lactate, Electrolytes
pH, pO2, pCO2
Which of the following is part of the Venous blood when doing a complete blood gas assessment:
pH, pO2, pCO2, CO2 (HCO3), Lactate, Electrolytes
CO2 (HCO3), Lactate, Electrolytes
What is the specimen type for Blood Gas Analysis?
Arterial
You should collect Blood Gas Specimen in what?
Heparin Anticoagulant
If transport and testing time will be > 30 minutes for a Blood Gas Specimen what should you do?
Put on Ice
True or False:
Potentiometry measures the voltage difference between two electrodes
True
True or False:
The reference electrode produces a known, constant potential (voltage)
True
True or False:
The indicator (sample) electrode “selects” for one ion of interest
True
pCO2 electrode (Severinghaus electrode)
Consists of what?
pH electrode with a CO2-permeable membrane
pCO2 electrode (Severinghaus electrode) – what happens as CO2 diffuses from the blood into a bicarbonate buffer layer?
pH of the buffer is lowered and H ions are released
What does Amperometry measure?
The current that flows when a constant voltage is applied to the system
True or False:
pO
2
electrode (Clarke electrode) –
Current is produced by the loss of electrons as the oxygen molecules contact a cathode
True
If pCO2 <35 & HCO3 is normal = _____
Respiratory
If pCO2 >45 & HCO3 is normal = _____
Respiratory
If HCO3 <22 & pCO2 is normal = _____
Metabolic
If HCO3 >26 & pCO2 is normal = _____
Metabolic
If both pCO2 and HCO3 are abnormal, what do you divide the PCO2 value by before multiplying by 100?
40
If both pCO2 and HCO3 are abnormal, what do you divide the HCO3 value by before multiplying by 100?
24
True or False:
If both pCO2 and HCO3 are abnormal, The component furthest away from normal (100%) determines the primary problem
True
Define Therapeutic Drug Monitoring
Evaluation and analysis of circulating concentrations of prescribed drugs in serum, plasma or whole blood.
True or False:
It is difficult to measure a drug at its site of action, so blood levels are the best assessment
True
List the 5 Steps of Drug Disposition
1. Administration
2. Absorption
3. Protein-Binding
4. Distribution
5. Drug Elimination/Clearance
Define the following step of Drug Disposition:
Administration
How the drug gets in
Define the following step of Drug Disposition:
Absorption
From site of administration into the bloodstream.
Define the following step of Drug Disposition:
Protein-Binding
A portion of the drug binds to proteins, but only the free fraction is active and can illicit a biological response
Define the following step of Drug Disposition:
Distribution
Movement of drug into its target tissue
Define the following step of Drug Disposition:
Elimination/Clearance
Renal filtration, liver metabolism, or both
Gaseous expiration from lungs
Dosing is based on what?
The amount of drug Expected to remain Free
True or False:
Changes in protein levels will affect the amount of free drug
True
True or False:
Toxic symptoms may appear at a drug concentration considered to be therapeutic
True
Define:
Pharmacokinetics
Mathematical modeling of drug concentration in circulation, used to establish dosage regimens
Pharmacokinetics Half-Life =
The time needed for the concentration of
a drug to decrease by one half
x

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