Deck 8: Acid Base Balance

Question 1

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 1

E

Question 2

Which of the following buffer systems buffers both extracellular and intracellular fluids?

A) the phosphate buffer system
B) the protein buffer system
C) the hemoglobin buffer system
D) the bicarbonate-carbonic acid buffer system
E) the monosodium buffer system

Answer 2

B

Question 3

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

Answer 3

D

Question 4

What do acidic substances "donate" in chemical reactions?

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

Question 5

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 6

Ammonia is best classified as a(n) ____.

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

Question 7

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

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

Question 8

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 9

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 10

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 11

Which of the following buffer systems acts as the primary buffer against non-carbonic-acid changes in the extracellular fluid?

A) the phosphate buffer system
B) the protein buffer system
C) the hemoglobin buffer system
D) the bicarbonate-carbonic acid buffer system
E) the monosodium buffer system

Question 12

What is the 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 13

What is the normal pH range of serum in humans?

A) 7.35-7.45
B) 6.15-6.75
C) 5.4-5.6
D) 8.55-8.59
E) 4.0-5.0

Question 14

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

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

Question 15

Which of the following ions cannot cross the blood-brain barrier?

A) H⁺and Ca²⁺
B) H⁺and HCO^3-
C) HCO^3-and Cl^-
D) Na⁺and Cl^-
E) Na⁺and Ca²⁺

Question 16

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 17

The protein buffer system acts in the same fashion as which 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 18

Changes in respiration result in rapid changes in CO₂levels in infants due to their:

A) underdeveloped kidneys
B) immature immune systems
C) small livers
D) small lung capacities
E) tiny mouths

Question 19

Which of the following is a ketoacid that is produced during the metabolism in the body?

A) lactic acid
B) carbonic acid
C) acetic acid
D) hydroxybutyric acid
E) ethanoic acid

Question 20

What is the minimum pH of urine in humans?

A) 3.9
B) 3.2
C) 4.5
D) 5.8
E) 5.1

Question 21

Mr. X is a 56-year-old male admitted to a hospital for shortness of breath and breathing difficulties. He is diagnosed with pneumonia. He has a history of congestive heart failure, osteoarthritis, hypertension, gout, and coronary artery disease.
Height: 5'9"   Weight: 220 pounds

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 potassium

Question 22

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

A) metabolic alkalosis
B) metabolic acidosis
C) respiratory alkalosis
D) respiratory acidosis
E) cancer

Question 23

Mr. X is a 56-year-old male admitted to a hospital for shortness of breath and breathing difficulties. He is diagnosed with pneumonia. He has a history of congestive heart failure, osteoarthritis, hypertension, gout, and coronary artery disease.
Height: 5'9"   Weight: 220 pounds

Which compensatory disorder could Mr. X develop?

A) metabolic alkalosis
B) metabolic acidosis
C) respiratory alkalosis
D) respiratory acidosis
E) physical acidosis

Question 24

Pickwickian syndrome is characterized by:

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

Question 25

Mr. X is a 56-year-old male admitted to a hospital for shortness of breath and breathing difficulties. He is diagnosed with pneumonia. He has a history of congestive heart failure, osteoarthritis, hypertension, gout, and coronary artery disease.
Height: 5'9"   Weight: 220 pounds

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

Mr. X is a 56-year-old male admitted to a hospital for shortness of breath and breathing difficulties. He is diagnosed with pneumonia. He has a history of congestive heart failure, osteoarthritis, hypertension, gout, and coronary artery disease.
Height: 5'9"   Weight: 220 pounds
Mr. X is likely to have which acid-base disorder?

A) physical acidosis
B) respiratory acidosis
C) respiratory alkalosis
D) metabolic acidosis
E) metabolic alkalosis

Question 27

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

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

Question 28

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

A) physical acidosis
B) metabolic acidosis
C) metabolic alkalosis
D) respiratory acidosis
E) respiratory alkalosis

Question 29

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 30

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 31

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 32

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

A) 95% or higher
B) between 90% and 92%
C) 87% or lower
D) between 57% and 59%
E) 19.1% or lower

Question 33

Which medical condition occurs when the retention of carbon dioxide causes a decrease in the pH of the body?

A) metabolic alkalosis
B) metabolic acidosis
C) diabetic alkalosis
D) respiratory alkalosis
E) respiratory acidosis

Question 34

Where is the respiratory center in the brain located?

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

Question 35

Diabetic ketoacidosis results in metabolic acidosis due to both increased production of and the inability to metabolize:

A) ketones
B) lactates
C) bicarbonates
D) water
E) ammonia

Question 36

Identify the equation that is used to calculate the anion gap.

A) Na⁺- (Cl^-+ HCO₃^-)
B) K⁺- (Cl^-+ HCO₃^-)
C) Na⁺- (HCO₃^-)
D) K⁺- (HCO₃^-)
E) Na⁺- (Cl^-)

Question 37

Mr. X is a 56-year-old male admitted to a hospital for shortness of breath and breathing difficulties. He is diagnosed with pneumonia. He has a history of congestive heart failure, osteoarthritis, hypertension, gout, and coronary artery disease.
Height: 5'9"   Weight: 220 pounds

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 38

What is the most common cause of metabolic acidosis?

A) asthma
B) morbid obesity
C) intestinal fistulas
D) diarrhea
E) overconsumption of coffee

Question 39

Identify the amino acid that is converted to ammonia in the renal tubular cells of the kidney.

A) methionine
B) cysteine
C) alanine
D) glutamine
E) valine

Question 40

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) physical acidosis

Question 41

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

Question 42

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

Question 43

_______________ is the actual decrease in pH within the body to

Question 44

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

Question 45

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

Question 46

Water is considered neutral at pH _______________.

Question 47

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

Question 48

Nonvolatile or _______________ acids include those inorganic acids that are produced during the metabolism of carbohydrate, protein, and lipid.

Question 49

Carbonic acid is produced in the largest quantity and is the major source of hydrogen ions in the body.

Question 50

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

Question 51

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

Question 52

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

Question 53

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

Question 54

_______________ are also produced as a result of starvation or fasting, fever, exercise, and some disease states.

Question 55

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

Question 56

Free hydrogen ions combine with _______________ to form ammonium.

Question 57

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

Question 58

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

Question 59

In respiratory alkalosis, the major cellular buffering defense available is expiration of CO₂by the lungs.

Question 60

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

Question 61

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

Question 62

Describe the abbreviation pK.

Question 63

Explain buffers.

Question 64

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

Question 65

Describe the groups of acids found in the human body.

Question 66

Explain the pH scale.

Question 67

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.

Question 68

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

Question 69

Explain Kussmaul breathing.

Question 70

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

Question 71

Discuss the etiology of metabolic alkalosis.

Question 72

List four types of acid-base disorders.

Question 73

The _______________ represents the difference between unmeasured anions and cations.

Question 74

The _______________ removes gastric secretions in order to prevent vomiting or aspiration.

Question 75

An example of alkalosis without fluid imbalance would include primary or secondary _______________.

Question 76

List three physiological means by which the body can accommodate all the hydrogen ions it constantly produces.

Question 77

The acute response to respiratory alkalosis (within the first 24 hours) is a shift of acid from the _______________ to the _______________ with an accompanying exchange of bicarbonate for chloride.

Question 78

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

Question 79

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

Question 80

Describe the clinical manifestations of respiratory acidosis.