Exam 4 Chemistry Review/Study Questions Part 5

question

What are the causes of Metabolic Acidosis?
answer

Diabetic ketoacidosis or starvation
Renal tubular acidosis
Diarrhea (loss of HCO3)
Lactic acid production (tissue hypoxia)
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What are the compensation methods for Metabolic Acidosis?
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Hyperventilation to blow off excess CO2
Renal excretion of H+ or retention of HCO3 (if kidney disease is not the cause)
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What are the causes of Metabolic Alkalosis?
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Excessive antacids
Vomiting (loss of HCl)
Diuretics (loss of K and H)
Alkaline Tide following heavy meals
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What are the compensation methods for Metabolic Alkalosis?
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Hypoventilation to retain CO2
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What are the causes of Respiratory Acidosis?
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Emphysema
COPD or strangulation
Pneumonia
Morphine or barbiturates (especially with alcohol)which suppress breathing
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What are the compensation methods for Respiratory Acidosis?
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Kidneys increase excretion of H and retention of HCO3
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What are the causes of Respiratory Alkalosis?
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Chemical stimulants
Fever or an increased environmental temp
Hysteria, anxiety, prolonged
crying
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What are the compensation methods for Respiratory Alkalosis?
answer

Kidneys excrete HCO3 and retain H
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Salicylate Poisoning: Initial ______, then ______
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Metabolic Acidosis
Respiratory Alkalosis
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Strangulation or Alco OD: Initial ______ leading to ______
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Respiratory Acidosis
Metabolic Acidosis
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DKA with vomiting: ______ plus ______
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Metabolic acidosis
Metabolic alkalosis
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Hyperventilation is the compensation mechanism for what Acid-Base disorder?
answer

Metabolic Acidosis
question

Hypoventilation is the compensation mechanism for what Acid-Base disorder?
answer

Metabolic Alkalosis
question

Retention of HCO3, Secretion of H, is the compensation mechanism for what Acid-Base disorder?
answer

Respiratory Acidosis
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Retention of H, Secretion of HCO3, is the compensation mechanism for what Acid-Base disorder?
answer

Respiratory Alkalosis
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Total O2 content is the sum of what?
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Oxygen bound to Hgb Plus the amount dissolved in the plasma (pO2)
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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
answer

pH, pO2, pCO2
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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
answer

CO2 (HCO3), Lactate, Electrolytes
question

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
answer

pH, pO2, pCO2
question

Which of the following is part of the Venous blood when doing a complete blood gas assessment:
pH, pO2, pCO2, CO2 (HCO3), Lactate, Electrolytes
answer

CO2 (HCO3), Lactate, Electrolytes
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What is the specimen type for Blood Gas Analysis?
answer

Arterial
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You should collect Blood Gas Specimen in what?
answer

Heparin Anticoagulant
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If transport and testing time will be > 30 minutes for a Blood Gas Specimen what should you do?
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Put on Ice
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True or False:
Potentiometry measures the voltage difference between two electrodes
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True
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True or False:
The reference electrode produces a known, constant potential (voltage)
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True
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True or False:
The indicator (sample) electrode “selects” for one ion of interest
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True
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pCO2 electrode (Severinghaus electrode)
Consists of what?
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pH electrode with a CO2-permeable membrane
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pCO2 electrode (Severinghaus electrode) – what happens as CO2 diffuses from the blood into a bicarbonate buffer layer?
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pH of the buffer is lowered and H ions are released
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What does Amperometry measure?
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The current that flows when a constant voltage is applied to the system
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True or False:
pO
2
electrode (Clarke electrode) –
Current is produced by the loss of electrons as the oxygen molecules contact a cathode
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True
question

If pCO2 <35 & HCO3 is normal = _____
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Respiratory
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If pCO2 >45 & HCO3 is normal = _____
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Respiratory
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If HCO3 <22 & pCO2 is normal = _____
answer

Metabolic
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If HCO3 >26 & pCO2 is normal = _____
answer

Metabolic
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If both pCO2 and HCO3 are abnormal, what do you divide the PCO2 value by before multiplying by 100?
answer

40
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If both pCO2 and HCO3 are abnormal, what do you divide the HCO3 value by before multiplying by 100?
answer

24
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True or False:
If both pCO2 and HCO3 are abnormal, The component furthest away from normal (100%) determines the primary problem
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True
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Define Therapeutic Drug Monitoring
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Evaluation and analysis of circulating concentrations of prescribed drugs in serum, plasma or whole blood.
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True or False:
It is difficult to measure a drug at its site of action, so blood levels are the best assessment
answer

True
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List the 5 Steps of Drug Disposition
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1. Administration
2. Absorption
3. Protein-Binding
4. Distribution
5. Drug Elimination/Clearance
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Define the following step of Drug Disposition:
Administration
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How the drug gets in
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Define the following step of Drug Disposition:
Absorption
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From site of administration into the bloodstream.
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Define the following step of Drug Disposition:
Protein-Binding
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A portion of the drug binds to proteins, but only the free fraction is active and can illicit a biological response
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Define the following step of Drug Disposition:
Distribution
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Movement of drug into its target tissue
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Define the following step of Drug Disposition:
Elimination/Clearance
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Renal filtration, liver metabolism, or both
Gaseous expiration from lungs
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Dosing is based on what?
answer

The amount of drug Expected to remain Free
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True or False:
Changes in protein levels will affect the amount of free drug
answer

True
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True or False:
Toxic symptoms may appear at a drug concentration considered to be therapeutic
answer

True
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Define:
Pharmacokinetics
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Mathematical modeling of drug concentration in circulation, used to establish dosage regimens
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Pharmacokinetics Half-Life =
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The time needed for the concentration of
a drug to decrease by one half

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