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Question | Answer |
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Define P50. Indicated what will happen to the normal value with a shift to the right and left. | The partial pressure at hemoglobin is 50 percent saturated with oxygen.A shift to the right will increase the P50 while a shift to the left will decrease the P50 Normal P50 27 mmhg |
Co2 diffuses across the A-C membrane how many times faster than O2 | 20 times faster |
What is dead space ventilation? | Volume of inspired air that does not reach the alveoli for gas exchange |
What is shunted blood? What can cause it? | V/Q ratio decreases PAco2 increases PaO2 decreases.CausesCOPD(emphysema, bronchitis, asthma)Restrictive lung disease( Pneumonia, fibrosis, hypoventilation) |
What factors can shift the ODC to the left? | Hgb has more affinity for O2causes Hgb to hold O2 Alkalosis-Ph increasesCo2 DecreasesTemperature increases2, 3 DP6 decreases |
Explain how capillary shunting is refractory to oxygen | O2 cannot diffuse capillary blood because of restriction |
List the causes of hypoxemia | 1. Low alveolar oxygen tension2. Diffusion defects3. Ventilation- perfusion mismatches4. Pulmonary shunting |
Which compartment of the blood transports the most Co2 | 63% bicarbonate |
Discuss the Bohr Effect and Haldane Effect | Haldane Effect - deoxygenated blood enhances loading of CO2 and oxygenated blood enhances the offload of CO2 Bohr Effect- the effect of PCO2 and Ph on the oxyhemoglobin curve. |
What is anatomic shunt? What is the normal value we see? | When more O2 does not help refractory to oxygen therapy 3% normal value |
List the factors that move the ODC to the right | Temperature IncreasePh increasePCO2 increaseDPG increase |
In the upright lung is the V/Q high or low at the base | Highest at the apex and lowest at the bases |
What conditions make RBC concentration of 2,3, DPG decrease | Decrease in Ph Store bloodIncrease hypoxiaAnemiaIncrease Ph |
What is the first sign of hypoxemia? | Tachycardia |
If the ventilation decreases but perfusion stays the same has the V/ Q increased or decrease | Decrease |
Define respiratory acidosis and respiratory alkalosis | Respiratory acidosis or acute ventilation failure- hypoventilation caused by narcotics barbiturates decrease Pao2 increase PaCo2Respiratory Alkalosis- POCO2 decrease with hyperventilation Ph increase |
Calculate RQ if the tissue consumes 290ml of oxygen and produces 215ml of CO2 | CO2/O2 = .74 |
Define alveolar dead space and anatomical dead space | Alveolar is ventilated but not perfused with blood-air is flowing but no gas exchange blood is stopped in a capillary amount of space is unpredictableAnatomical volume of gas in conducting airways equals 1ml/lbs of body wt. |
HCO3 to H2CO3 ratio 15:1.Is this acidosis or alkalosis? | Acidosis because it is below 20:1 |
Define physiological dead space | Sum of anatomic and alveolar dead space |
How much CO2 does the body produce normally at rest in one minute? How much oxygen is consumes normally in one minute? | 200mlCO2/min 250mlO2/min |
Is a HCO3 to H2CO2 ratio 23:1 acidic or alkalotic? | Alkalosis because the 23:1 is higher then 20 making it alkalosis |
What happens PaO2 and CaO2 in hypoxic hypoxia? What happens to them in anemia hypoxia? | Hypoxic hypoxia- PaO2 decrease CaO2 increaseAnemic hypoxia- normal Pao2 CaO2 decreases |
If the ventilation increases but perfusion stays the same what happens to the V/Q ratio? | Increases |
What is acute ventilatory failure? What are it causes? | Increase PaCO2 decrease PaO2CausesCOPDGeneral anesthetics Head trauma Neurological disordersHypoventilation caused by an overdose of narcotics |
Discuss the concept of the ion gap. What is the normal range for the ion gap. | Is the pt. acidosis caused by fixed acids or by a loss of HCO3Na+=140meq/l Cl=105 meq/l HCO3= 24mq/l9-14meq/l a gap increase 14 represents metabolic acidosis |
Be sure you can interpret ABGs | Ph 7.35 to 7.45Below 7.35 acidosis Above 7.45 alkalosisPaCo2 35 to 45Below 35 acidosis Above 45 alkalosisHCO3 22 to 26 below 22 acidosis above alkalosis |
Causes respiratory acidosis and respiratory alkalosis | respiratory acidosis Causes: COPD, general anesthetics, head trauma neurological disorderrespiratory alkalosis Causes: pain aniexty fever brain inflammation hypoxia stimulant drugs |