Deck 8: Acid Base Balance

Question 1

To maintain pH, a healthy, normal functioning kidney will reabsorb the majority of:

A) ​H+
B) ​H2O
C) ​nitrogen
D) ​phosphate
E) HCO3-

Answer 1

E

Question 2

What is the most biochemically important volatile acid in the body?

A) ​hydrochloric acid
B) ​acetic acid
C) ​phosphoric acid
D) ​nitric acid
E) ​carbonic acid

Answer 2

E

Question 3

What is the normal pH range of blood serum in humans?

A) ​7.35 - 7.45
B) ​7.15 - 7.75
C) ​7.4 - 7.6
D) ​7.55 - 7.59
E) ​7.0 - 8.0

Answer 3

A

Question 4

What ions do NOT cross the blood-brain barrier?

A) ​H+ and Ca2+
B) ​H+ and HCO3-
C) ​HCO3- and Cl-
D) ​Na+ and Cl-
E) ​Na+ and Ca2+

Question 5

In human physiology, which two groups of acids are most important?

A) ​acidic and alkaline
B) ​gastric and intestinal
C) ​volatile and nonvolatile
D) ​reactive and nonreactive
E) ​digestive and enzymatic

Question 6

What happens to ventilation when acidosis occurs and the buffer system is not adequate to control the acidosis?

A) ​not affected
B) ​becomes erratic
C) ​suddenly stops
D) ​hyperventilation
E) ​hypoventilation

Question 7

What is the minimum pH of urine in humans?

A) 3.9​
B) ​4.2
C) ​4.5
D) ​4.8
E) ​5.1

Question 8

Acidemia is the actual decrease in pH within the body to:

A) ​<7.75
B) ​<7.6
C) <7.55
D) ​<7.45
E) ​<7.35

Question 9

The protein buffer system acts in the same fashion as what other buffer system?

A) ​phosphate buffer system
B) ​bicarbonate-carbonic acid buffer system
C) ​hemoglobin buffer system
D) ​monosodium buffer system
E) ​disodium buffer system

Question 10

Within the bloodstream where is hemoglobin present?

A) ​red blood cells
B) ​serum
C) ​lymph
D) ​endothelium
E) ​white blood cells

Question 11

What is the best definition of metabolic alkalosis?

A) ​condition resulting from either retention of cations or loss of nonvolatile acid
B) ​condition resulting from either retention of bicarbonate or calcium
C) ​condition resulting from either retention of bicarbonate or loss of nonvolatile acids
D) ​a kidney disease resulting in hyperventilation
E) ​a liver disease resulting in reduced respiration

Question 12

Ammonia is best classified as a(n) ____.

A) ​buffer
B) ​acid
C) ​base
D) ​electrolyte
E) ​hydrogen donator

Question 13

Fixed acids are categorized as:

A) ​stable or unstable
B) ​organic or inorganic
C) ​reactive or unreactive
D) ​endocrine or exocrine
E) ​donating or accepting

Question 14

What is the most predominant base involved in human acid-base balance?

A) ​bicarbonate
B) ​alkaline water
C) ​calcium carbonate
D) ​magnesium citrate
E) ​ammonia

Question 15

Changes in respiration result in rapid changes in CO2 levels in infants due to their:

A) ​under-developed kidneys
B) ​immature immune systems
C) ​small livers
D) ​small lung capacities
E) ​tiny mouths

Question 16

The lungs are unable to eliminate which types of acids?

A) ​nonvolatile acids
B) ​volatile acids
C) ​reactive acids
D) ​nonreactive acids
E) ​enzymatic acids

Question 17

The term hypercapnia indicates that there is ____.

A) ​too much calcium in the blood
B) ​a lack of the blood gas carbon dioxide
C) ​a lack of the blood gas oxygen
D) ​an excess of the blood gas carbon dioxide
E) ​an excess of the blood gas oxygen

Question 18

Which fluid is most likely to be buffered by the phosphate buffer system?

A) ​blood
B) ​saliva
C) ​extracellular fluid
D) ​urine
E) ​lymph

Question 19

What do acidic substances "donate" in chemical reactions?

A) ​oxygen atoms
B) ​hydrogen ions
C) ​protons 
D) ​carbon atoms
E) ​chloride ions

Question 20

What does the hemoglobin buffer system primarily buffer against?

A) ​uric acid changes
B) ​kidney phosphate changes
C) ​carbonic acid changes
D) ​blood oxygen changes
E) ​excess red blood cell production

Question 21

In terms of mixed acid-base disorders, which of the following is NOT possible?

A) ​metabolic acidosis and respiratory acidosis
B) ​respiratory acidosis and respiratory alkalosis
C) ​metabolic alkalosis and respiratory alkalosis
D) ​ metabolic acidosis and respiratory alkalosis
E) ​metabolic alkalosis and respiratory acidosis

Question 22

What is the most common cause of metabolic acidosis?

A) ​asthma
B) ​morbid obesity
C) ​intestinal fistulas
D) ​excessive diarrhea
E) ​over-consumption of coffee

Question 23

Poisoning from the consumption of ethylene glycol (antifreeze) leads to:

A) ​metabolic alkalosis
B) ​metabolic acidosis
C) ​respiratory alkalosis
D) ​respiratory acidosis
E) ​lactic acidosis

Question 24

Sleep apnea can potentially cause which acid-base disorder?

A) ​respiratory alkalosis
B) ​respiratory acidosis
C) ​metabolic alkalosis
D) ​metabolic acidosis
E) ​kidney disease

Question 25

What factor is contributing most to his acid-base disorder?

A) ​gout
B) ​high cholesterol
C) ​pneumonia / shortness of breath
D) ​osteoarthritis
E) ​hypertension

Question 26

Prolonged vomiting is likely to lead to what type of acid-base imbalance?

A) ​respiratory alkalosis
B) ​respiratory acidosis
C) ​metabolic alkalosis
D) ​ metabolic acidosis
E) ​lactic acidosis

Question 27

What does the anion gap measure?

A) ​the total quantity of anions
B) ​the difference between unmeasured anions and cations
C) ​the ratio of different anions
D) ​the effect of anions on the blood
E) ​the effect of anions on the kidneys

Question 28

What is the normal value for oxygen saturation in the blood?

A) ​95% or higher
B) ​between 94-96%
C) ​97% or higher
D) ​between 97-99%
E) ​99.1% or higher

Question 29

Where is the respiratory center in the brain located?

A) ​pineal gland
B) ​pituitary gland
C) ​posterior cerebrum
D) ​pons
E) ​medulla

Question 30

Mr. X is likely to have which acid-base disorder?

A) ​lactic acidosis
B) ​respiratory acidosis
C) ​respiratory alkalosis
D) ​metabolic acidosis
E) ​metabolic alkalosis

Question 31

What treatment would be the most effective for his acid-base disorder?

A) ​treat pneumonia and lose weight
B) ​control blood pressure and reduce blood cholesterol
C) ​anti-inflammatories for osteoarthritis and lose weight
D) ​insulin therapy and control blood pressure 
E) ​manage heart condition and reduce blood cholesterol

Question 32

What condition occurs when the retention of carbon dioxide causes an excess of acid in relationship to base?

A) ​metabolic alkalosis
B) ​ metabolic acidosis
C) ​increase in blood pH
D) ​respiratory alkalosis
E) ​respiratory acidosis

Question 33

What is the reference range for the calculated anion gap?

A) ​0.1-0.9 mEq/L
B) ​1.0-2.9 mEq/L
C) ​5.0-6.5 mEq/L
D) ​8-16 mEq/L
E) ​10-25 mEq/L

Question 34

What compensatory disorder could Mr. X develop?

A) ​metabolic alkalosis
B) ​metabolic acidosis
C) ​respiratory alkalosis
D) ​respiratory acidosis
E) ​lactic acidosis

Question 35

With diabetic ketoacidosis, metabolic acidosis occurs due to an inability to metabolize:

A) ​ketones
B) ​lactate
C) ​bicarbonate
D) ​water
E) ​ammonia

Question 36

What is the primary indication that Mr. X has an acid-base disorder?

A) ​mildly elevated creatinine
B) ​mildly low sodium
C) ​borderline low albumin
D) ​ high blood pH
E) ​borderline high bicarbonate

Question 37

Respiratory alkalosis is generally a result of conditions that cause ____.

A) ​hypoglycemia
B) ​decreased heart rate
C) ​hyperventilation
D) ​hypoventilation
E) ​kidney disease

Question 38

Catecholamines are drugs that can cause what type of acid-base imbalance?

A) ​lactic acidosis
B) ​metabolic acidosis
C) metabolic alkalosis
D) ​respiratory acidosis
E) ​respiratory alkalosis

Question 39

How many major types of simple acid-base disorders exist?

A) ​two
B) ​three
C) ​four
D) ​five
E) ​six

Question 40

Pickwickian syndrome is characterized by.

A) ​morbid obesity, breathing problems, respiratory acidosis
B) ​morbid obesity, breathing problems, respiratory alkalosis
C) ​liver disease, circulation problems, respiratory acidosis
D) ​kidney disease, circulation problems, respiratory alkalosis
E) ​anorexia nervosa, breathing problems, respiratory alkalosis

Question 41

_______________ is the actual decrease in pH within the body to <7.35.

Question 42

The kidney  uses _______________ and _______________ as buffers because it cannot excrete bicarbonate at the same time as hydrogen ions.

Question 43

Assessment of acid-base balance requires more than simply examining laboratory values.

Question 44

Metabolic acidosis refers to all types of acidosis that are not caused by excessive ammonia.

Question 45

 _______________ acids are those that can be converted to a gaseous form and eliminated by the lungs.

Question 46

Free hydrogen ions combine with _______________ to form ammonium.

Question 47

Nonvolatile or _______________ acids are produced as end products of carbohydrate, protein, and lipid metabolism.

Question 48

Bases are substances that can accept or receive a hydrogen ion.

Question 49

Lactic acidosis occurs as a result of increased production of lactate or ketoacids.

Question 50

The pH of a substance is measured in a range from 1 to 12.

Question 51

Buffers are present in all body fluids -- both extracellular and intracellular.

Question 52

In respiratory alkalosis, the major cellular buffering defense available is inspiration of CO2 by the lungs.

Question 53

_______________ present in the plasma can act as buffers; their contribution is most important intracellularly.

Question 54

The concentration of _______________ is used to measure acidity.

Question 55

The Henderson-Hasselbach equation has been used to explain the interrelationships between H2O, HCO3-, and pH.

Question 56

Water is considered neutral pH at _______________.

Question 57

Nonvolatile acids include those inorganic acids that are formed during metabolism of carbohydrate, protein, and lipid.

Question 58

The _______________ role in controlling both H+ and HCO3- is a critical component for the maintenance of pH homeostasis.

Question 59

An important buffer system within red blood cells and tubules of the kidney is the ammonium buffer.

Question 60

The primary buffer in extracellular fluid (ECF) is the _______________ buffer system.

Question 61

The acute response to respiratory alkalosis (within the first 24 hours) is a shift of acid from the _______________ to the _______________.

Question 62

Symptoms of metabolic acidosis may include changes in respiration, such as _______________ breathing.

Question 63

There are no specific signs and symptoms for metabolic _______________.

Question 64

_______________ is the ion that moves in the opposite direction of HCO3-.

Question 65

Explain buffers.

Question 66

Explain Kussmaul breathing.

Question 67

Explain the pH scale.

Question 68

List the 3 ways the body accommodates all the hydrogen ions it produces.

Question 69

The _______________ represents the difference between unmeasured anions and cations.

Question 70

Discuss the effect of acid and base shifts on electrolyte balance.

Question 71

Respiratory diseases, such as chronic obstructive pulmonary disease, result in inability to maintain adequate oxygenation or release of _______________.

Question 72

An example of alkalosis without fluid imbalance is in the condition of primary or secondary _______________.

Question 73

Describe the abbreviation pK.

Question 74

Describe the clinical manifestations of respiratory acidosis.

Question 75

Metabolic alkalosis and respiratory acidosis may occur when a patient with chronic obstructive pulmonary disease receives _______________.

Question 76

Carbonic _______________ inhibitors such as the drug acetazolamide can result in excessive loss of base while inhibiting production of carbonic acid in the kidney.

Question 77

Discuss the etiology of metabolic alkalosis.

Question 78

List the 4 types of acid-base disorders.

Question 79

Describe the role of acids in the human body.

Question 80

When assessing acid-base balance, the _______________ response is determined first, but an investigation of the _______________ response or compensation as well allows for a complete assessment.