Free Essay

Medical

In:

Submitted By shinklan
Words 2283
Pages 10
第四章 酸碱平衡紊乱

复习提要

一、机体对酸碱平衡的调节

(一)血液缓冲系统的调节作用
1. 四个主要缓冲对 NaHCO3/H2CO3 Na2HPO3/NaH2PO4 B 血浆蛋白/H 血浆蛋白 B 血红蛋白/H 血红蛋白
2.缓冲反应 HCL+NaHCO3→ H2CO3+NaCl (强酸) (弱酸) H2O+CO2 (肺呼出) NaOH+H2CO3 →NaHCO3+H2O (强碱) (弱碱) (肾排出) (二)组织细胞的调节作用 通过细胞膜内外H+—K+离子的交换实现 (三)肺的调节作用 H++HCO3- →H2CO3 →H2O+CO2 排出一个CO2,等于排出一个H+ (四)肾脏的调节作用

1.泌H+和重吸收NaHCO3

2.产NH3排NH4+

3.排出可滴定酸

二、反映血液酸碱平衡状态的指标和意义

(一)Henderson-Hasselbalch 方程式 1.方程式 : [BA] pH =Pka+log [HA] [HCO3-] =Pka+log [H2CO3] 24 =6.1+log 1.2 =6.1+1.301=7.401

2.意义

①血液pH值取决于NaHCO3和H2CO3的浓度比值
②血液内的H2CO3浓度受呼吸因素调节,NaHCO3浓度主要受肾脏的调节
③如果NaHCO3或H2CO3其中任何一项浓度发生改变,另一项通过代偿活动作相应增减,pH值仍在正常范围,为代偿性,反之,为失代偿性 (二)反映血液酸碱平衡的常用指标

1.H+浓度和PH值

H+浓度的负对数,即为PH值,正常人动脉血液的PH值为7.35~7.45。

2.二氧化碳分压(PaCO2)

①溶解在血浆中的CO2分子产生的压力或人动脉血PaCO2正常范围33~47mmHg反映呼吸因素的最佳指标
②PaCO247mmHg. ,表示肺通气不足 原发性呼吸性酸中毒 继发性代谢性碱中毒

3.缓冲碱(BB)

①血液中一切具有缓冲作用的碱性物质的总和正常范围45~55mmol/L 反映代谢性因素的指标
②BB>55mmol/ L为原发性代谢性碱中毒或继发性呼吸性酸中毒 BB3mmol/L原发性代谢性碱中毒或继发性呼吸性酸中毒 BD>3mmol/L原发性代谢性酸中毒或继发性呼吸性碱中毒

5.标准碳酸氢盐(SB)与实际碳酸氢盐(AB)

①SB是血标本指标准条件下,测得的血浆HCO3-的浓度,判断代谢性因素的指标,正常值为22~27mmol/L SB>27mmol/L原发性代谢性碱中毒或继发性呼吸性酸中毒 SBSB指示CO2潴留,见于原发性呼吸性酸中毒及继发性代谢性碱中毒 ABSB

4.对机体的影响

①中枢神经系统功能紊乱:烦燥不安,精神错乱。 ②对神经肌肉的影响:手足抽搦,面部和肢体肌肉抽动。 ③低钾血症:心律失常。

5.防治原则

①积极防治原发病 ②合理选用药物纠正碱中毒 (二)呼吸性碱中毒 血浆H2CO3浓度原发性降低

1.原因和机制

①精神性过度通气
②乏氧性缺氧
③机体代谢亢进
④人工呼吸过度

2.机体代偿调节

①细胞内外离子交换和细胞内液缓冲
②肾脏代偿调节(与代谢性碱中毒一致)

3.血气分析

过度通气PaCO2降低,AB减少,ABSB能有: A.代谢性酸中毒 B.呼吸性酸中毒 C.呼吸性碱中毒 D.代谢性碱中毒 E.混合性碱中毒 23. 对呼吸性H+的缓冲,主要靠:
A.HCO3-缓冲系统 B.HCO3-以外的缓冲系统
C.血浆蛋白缓冲系统 D.磷酸盐缓冲系统
E.其他缓冲系统
24.对代谢性H+的缓冲主要靠:
A.HCO3-缓冲系统 B.血浆蛋白缓冲系统
C.血红蛋白缓冲系统 D.磷酸盐缓冲系统
E.HbO2缓冲系统
25. 某慢性肺心病患者,血气分析及电解质测定结果如下:
PH 7.40 PaCO2 67mmHg, HCOI3- 40mmol/人 血Na+
140mmol/人CI- 90mmol/人诊患者的酸碱平衡诊断为HCO3-:
A.呼吸性酸中毒
B.代谢性碱中毒
C.代谢性酸中毒合并代谢性碱中毒
D.呼吸性酸中毒合并代谢性碱中毒
E.呼吸性碱中毒
26.某肺心病患者,血气分析及电解质测定结果如下:PH 7.26,PaCO2 85.8mmHg, HCO3- 37.8mmol/人 CI- 90mmol/人 Na+ 140mmol/人 下列诊断中最有可能是哪一种: A.呼吸性酸中毒 B.代谢性酸中毒 C.呼吸性酸中毒合并代谢性酸中毒 D.呼吸性酸中毒合并代谢性碱中毒 E.呼吸性碱中毒 27.肝功能异常并合并代谢性酸中毒患者,在纠正酸中毒时,不宜采用下列: 哪一种药物: A.0.9% NaCl B.1.5%NaHCO C.乳酸钠 D.三羟甲基氨基甲烷 E.氯化镁 28.代谢性酸中毒时,二氧化碳结合力为45~30%状态下,中枢神经系统 常出现: A.轻度的烦躁 B.萎糜 C.昏睡 D.昏迷 E.精神错乱 29.呼吸性酸中毒时,对中枢神经系统功能影响较大的因素是: A.氢离子浓度升高 B.r-氨基丁酸减少 C.PH下降 D.二氧化碳升高 E.高血钾 30.酸中毒时对机体影响危害最大的是: A.对中枢的抑制作用 B.对血管的扩张作用 C.高血钾对心肌细胞的毒性作用 D.低血钾对心肌细胞的毒性作用 E.溶骨作用 31.急性碱中毒时出现手足搐搦和四肢抽动的主要原因是: A.血清K+减少 B.血清Cl减少 C.血清Ca2+减少 D.血清Na+减少 E.血清Mg2+减少 32.下列指标中哪一项是反映酸碱平衡呼吸困难的最佳指标: A.pH B.PaCO C.SB D.AB 33. 低血钾引起的酸碱失衡紊乱的特点是:
___________________________________________________________
血浆HCO3- 血浆H+ 细胞内H+ 尿液H+
____________________________________________________________
A. ↓ ↑ ↑ ↑
B. ↓ ↑ ↓ ↓
C. ↑ ↓ ↓ ↓
D. ↑ ↓ ↑ ↑
E. ↓ ↑ ↑ ↑ _____________________________________________________________ 34. 血气分析测定结果为PaCO2降低,同时伴有HCO3-升高,可诊断为: A.呼吸性酸中毒
B.代谢性酸中毒
C.呼吸性碱中毒
D.代谢性碱中毒
E.呼吸性碱中毒合并代谢性碱中毒 35.碱中毒时血红蛋白氧离曲线呈现: A.右移 B.左移 C.先左移后右移 D.先右移后左移 E.不移动 36.慢性呼吸性酸中毒时机体主要代偿方式是: A.细胞外液缓冲 B.呼吸代偿 C.细胞内缓冲 D.肾脏代偿 E.骨骼代偿 37.呼吸性酸中毒合并代谢性酸中毒可见于: A.慢性肺心病患者长期服用利尿剂 B.水杨酸中毒 C.心跳呼吸聚停 D.革兰阴性杆菌败血症 E.幽门梗阻长时间进食少 38. 血液中pH值主要取决于血浆中:
A.CO2CP B.PaCO2 C.HCO3-
D.HCO3-与H2CO3的比值 E. H2CO3 39. 反映血浆中HCO3-实际量的指标是:
A.碳酸氢盐缓冲系统 B.磷酸盐缓冲系统
C.血红蛋白缓冲系统 D.氧合血红蛋白缓冲系统
E.其他缓冲系统
40.慢性呼吸性酸中毒时,机体代偿的主要方式: A.细胞外液缓冲 B.呼吸代偿 C.细胞内缓冲 D.肾脏代偿 E.血液系统的缓冲
41.某溺水窒息患者,经抢救后其血气分析结果为:PH 7.15 PaCO2 80mmHg,HCO3- 27mmol/L应诊断:
A.代谢性酸中毒 B.代谢性碱中毒
C.急性呼吸性酸中毒 D.慢性呼吸性酸中毒 E.呼吸性碱中毒 42. 碱中毒时出现神经肌肉应激性亢进,手足抽搐的主要原因是:
A.血清K+减少 B.血清CI- 减少 C.血清Ca2+减少
D.血清Na+减少 E.血清Mg2+减少 43.不同类型脱水的分型依据是: A.体液丢失的总量 B.电解质丢失的总量 C.细胞外液的总量 D.细胞外液的晶体渗透压 E.细胞外液的胶体渗透压 44. 血浆中含量最多的阴离子是:
A.HCO3- B.HPO42- C.SO42- D.CI- E.NO2 45.体内体液中各部分间渗透压关系是: A.细胞内高于细胞外 B.细胞内低于细胞外 C.血浆低于组织间液 D.组织间液低于细胞内液 E.细胞内外基本相等 46. 细胞内外渗透压的平衡主要靠哪一种物质的移动来维持:
A.Na+ B.K+ C.H20 D.葡萄糖 E.Ca2+ 47. 组织间液和血浆所含的溶质含量的主要差别是:
A.Na+ B.CI C.蛋白质 D.有机酸 E.Ca2+ 48. 决定细胞外液渗透压的主要因素是:
A.球蛋白 B.白蛋白 C.Na+ D.K+ E.Ca2+ 49.中度高渗性脱水患者的失水量相当于体重的: A.1~2% B.2~5% C.5~10% D.10~15% E.15%~20% 50.低渗性脱水时,下列描述哪项正确: A.细胞外液渗透压增高,容量降低 B.细胞内液渗透压增高,容量降低 C.细胞外液渗透压降低,容量降低 D.细胞内液渗透压降低,容量降低 E细胞内液渗透压不变,容量不变 51.高渗性脱水患者的处理原则是补充: A.5%葡萄糖液 B.0.9%NaCl液 C.先5%葡萄糖液后0.9%NaCl液 D.先3%NaCl液后5%葡萄糖液 E.同时给予5%葡萄糖液和3%NaCI液 52."失盐性肾炎"患者的肾脏内,哪一部位对钠重呼吸发生障碍: A.近曲小管 B.髓袢升支粗段 C.髓袢降支 D.远曲小管和集合管 E.髓袢升支细段 53.低渗性脱水患者体液丢失的特点是: A.细胞内液和外液均有明显丢失 B.细胞内液无丢失,仅丢失细胞外液 C.细胞内液无丢失,仅丢失血浆 D.细胞内液无丢失,仅丢失组织间液 E.细胞内液丢失,细胞外液无丢失 54.下列哪一种情况的早期出现精神神经症状: A.急性水中毒 B.高渗性脱水 C.低渗性脱水 D.等渗性脱水 55.急性低钾血症对神经肌肉组织中生理的影响是: _____________________________________________________________ 静息电位(负值) 阈电位 静息电与阈电位差值 _____________________________________________________________ A.↑ 不变 ↑ B.↓ 不变 ↓ C.↑ ↑ 不变 D.↓ ↓ 不变 E.↓ ↓ 不变 _____________________________________________________________ 56.急性低钾血症时心肌电生理特点是: ___________________________________________________________ 静息电位与阈电位差值 兴奋性 ___________________________________________________________ A. ↑ ↑ B. ↓ ↓ C. ↑ ↓ D. ↓ ↑ E. 不变 不变 __________________________________________________________ 57.低钾血症对心肌的影响是: ___________________________________________________________ 兴奋性 传导性 自律性 收缩性 ____________________________________________________________ A. ↑ ↑ ↑ ↑ B. ↓ ↑ ↑ ↑ C. ↑ ↓ ↑ ↑ D. ↑ ↑ ↓ ↑ E. ↓ ↓ ↓ ↓ _____________________________________________________________ 58.高钾血症对心肌的影响是: ____________________________________________________________ 兴奋性 传导性 自律性 收缩性 _____________________________________________________________ A. ↑→↓ ↓ ↓ ↓ B. ↓→↑ ↓ ↓ ↓ C. ↓ ↑ ↑ ↑ D. ↑ ↓ ↓ ↓ E. ↓ ↓ ↓ ↓ ____________________________________________________________ 59.神经肌肉应激性增强可见于: A.低血磷 B.低血钾 C.高血钙 D.低血镁 E.高血钾 60.下列哪种情况可产生低镁血症: A.甲状旁腺功能低下 B.甲状腺激素分泌过多 C.促性腺激素分泌过多 D.肾上腺功能减退 E.高血钾 61.AG增高反映发生了: A.高氯血性代谢性酸中毒 B.正常氯血性代谢性酸中毒 C.代谢性碱中毒 D.呼吸性酸中毒 E.呼吸性碱中毒 62.从动脉抽取血样后,如不与大气隔绝,下列哪一项指标将受影响: A.SB B.AB C.BE D.BB E.BD 63.急性代谢性酸中毒,最主要的代偿方式是: A.肾脏代偿 B.血液代偿 C.呼吸代偿 D.细胞外液缓冲 E.骨骼缓冲 64.某慢性肾功能不全患者,因上腹部不适呕吐而急诊入院,血气分析结果:PH 7.39 PaCO2 43.8mmHg HCO3- 26.6mmol/人 Na+ 142mmol/人 Cl- 96.5mmol/人诊断属哪一种酸碱失衡:
A.AG增高性代谢性酸中毒
B.AG正常性代谢性酸中毒
C.AG增高性代谢性酸中毒合并代谢性碱中毒
D.AG正常性代谢性酸中毒合并代谢性碱中毒
E.AG增高性代谢性酸中毒合并呼吸性酸中毒
65.下列疾病中哪一种不引起高输出量性心衰: A.甲状腺功能亢进症 B.贫血 C.心肌病 D.维生素B1缺乏 E.动-静脉瘘 66.常引起呼吸性酸中毒合并代谢性酸中毒的疾病是: A.严重的肝功能衰竭合并败血症 B.严重的慢性阻塞性肺病合并中毒性休克 C.糖尿病患者合并剧烈呕吐 D.剧烈呕吐伴有严重腹泻 E.严重高热 67.剧烈呕吐伴有严重腹泻的患者可引起的酸碱平衡紊乱类型为: A.代谢性酸中毒合并代谢性碱中毒 B.代谢性酸中毒合并呼呼性碱中毒 C.代谢性碱中毒合并呼吸性碱中毒 D.代谢性碱中毒 E.代谢性酸中毒 68.剧烈呕吐合并感染并有发热时,易引起: A.呼吸性碱中毒+代谢性酸中毒 B.代谢性碱中毒+呼吸性碱中毒 C.代谢性碱中毒+呼吸性酸中毒 D.呼吸性酸中毒+代谢性酸中毒 E.代谢性碱中毒+代谢性酸中毒 69.下列哪一项混合性酸碱失衡不可能出现: A.代谢性酸中毒合并代谢性碱中毒 B.呼吸性酸中毒合并呼吸性碱中毒 C.代谢性酸中毒合并呼吸性碱中毒 D.代谢性酸中毒合并呼吸性酸中毒 E.代谢性碱中毒合并呼吸性碱中毒 70. 对代谢性H+的缓冲主要依靠:
A.HCO-3缓冲系统 B.血浆蛋白缓冲系统
C.Hb缓冲系统 D.磷酸盐缓冲系统
E.HbO2缓冲系统
71. 机体新陈代谢时产生的挥发性酸是:
A.r-羟丁酸 B.H2CO3 C.H2SO4 D.尿酸 E.磷酸 72.肾脏产氨的主要部位是: A.远曲小管 B.近曲小管 C.集合管 D.髓袢 E.肾小球 73.关于PH值的描述,下列哪项是错误的: A.PH值代表[H+]的负对数 B.可由Henderson-Hasselbalch公式计算 C.PH值的变化不能区别代谢性或呼吸性酸碱平衡紊乱 D.PH值正常表明无酸碱平衡紊乱 E.PH值正常不排除有酸碱平衡紊乱 74.下述哪种情况不引起呼吸性碱中毒: A.大气氧分压过低 B.人工呼吸时过度通气 C.长时间在密闭小室中 D.癔病发作 E.革兰阴性杆菌败血症 75. 血液中具有最强缓冲能力的缓冲对是:
A.NaHCO3/H2CO3
B.Na2HPO4/NaH2PO4
C.Na-Pr/H-Hb
D.KHCO3/H2CO3
E.K-Hb/H-Hb
76.下列哪一项混合性酸碱失衡不可能出现: A.代谢性酸中毒合并代谢性碱中毒 B.呼吸性酸中毒合并呼吸性碱中毒 C.代谢性酸中毒合并呼吸性碱中毒 D.代谢性酸中毒合并呼吸性酸中毒 E.代谢性碱中毒合并呼吸性碱中毒 77. PaCO2升高至何种程度能使肺的通气量增加2倍:
A.PaCO2为5.32kPa
B.<5.32KPa
C.>5.32kPa
D.>8.3kPa
E. >9.0kPa 78.下列哪一种对血PH意义是错误的:
A.PH= -Log[H+]
B.PH= Log[H+]
C.PH= pka +Log[HCO-]/0.03×PCO2
D.PH= 6.1+Log[HCO-]/HCO]
E.PH= 6.1+Log[HCO-]/ a×PCO 79.对二氧化碳结合力的表述,下列哪一项是错误的: A.其正常范围是25~35mmol/L B.是指血浆中化学结合的二氧化碳量 C.以容积表示时正常值为50-70ml% D.可以反映血浆中碳酸氢钠的含量 E.正常血浆平均为27mmol/L 80.能反映血液中全部缓冲碱的指标是: A.AB B.PaCO C.SB D.BB E.BE 81.PaCO<4.39KPa(33mmHg)常提示: A.代谢性碱中毒 B.呼吸性碱中毒 C.呼吸性酸中毒 D.代谢性碱中毒合并呼吸性酸中毒 E.代谢性酸中毒合并呼吸性酸中毒 82.AG增高提示机体可发生: A.高氯血性代谢性酸中毒 B.正氯血性代谢性酸中毒 C.代谢性碱中毒 D.呼吸性酸中毒 E.呼吸性碱中毒 83.酸中毒时血钾的变化规律是: A.升高 B.不变 C.降低 D.先升后降 E.先降后升 84.严重的心力衰竭患者发生酸碱平衡紊乱的类型: A.乳酸增多的代谢性酸中毒 B.酮体增多的代谢性酸中毒 C.代谢性碱中毒 D.呼吸性酸中毒 E.呼吸性酸中毒合并代谢性碱中毒 85. 溃疡病并发幽门梗阻患者,因反复呕吐入院,血气分析结果如下: PH>7.48,PaCO26.4kPa(48mmHg),HCO-336mmol/L该病人酸碱失衡的
类型是:
A.代谢性酸中毒 B.代谢性碱中毒 C.呼吸性酸中毒
D.呼吸性碱中毒 E.混合性酸碱中毒 86. 氯摄入不足引起代谢性碱中毒的机制是:
A.H+经消化道丢失过多
B.H+—Na+交换加强致重吸收HCO3-
C.H+—Na+交换减少,致HCO重吸增加
D.H+—Na+交换减少,致HCO重吸收减少
E.H+—Na+交换无改变而致HCO重吸收增加
87.呼吸性碱中毒,经肾脏代偿调节后,血生化指标常为: A.AB.SB.BB和CO C P均正常,BE正常 B.AB.SB.BB和CO C P均升高,BE负值升高 C.AB.SB.BB和CO C P均下降,BE负值增大 D.AB.SB.BB和CO C P均下降,BE增大 E. AB.SB.BB和CO C P均正常,BE减小 88.饥饿引起的酸碱平衡紊乱属于: A.乳酸酸中毒 B.酮症酸中毒 C.呼吸性酸中毒 D.呼吸性碱中毒 E.代谢性碱中毒 89.严重腹泻常引起: A.代谢性酸中毒 B.代谢性碱中毒 C.AG正常高氯血性酸中毒 D.AG增大低氯性酸中毒 E.呼吸性酸中毒 90.阴离子间隙(AG)增高的代谢性酸中毒常见于: A.腹泻 B.使用乙酰唑胺利尿 C.糖尿病 D.肾小管性酸中毒 E.大量输入生理盐水 91.输入大量生理盐水引起: A.AG增大,高氯性酸中毒 B.AG正常,低氯性中毒 C.AG增大,低氯血性酸中毒 D.AG正常,高氯血性酸中毒 E.AG降低性高氯性酸中毒 92.应用人工呼吸机治疗呼吸衰竭和无自主呼吸的病人,若通气量过小,可导致: A.呼吸性酸中毒 B.呼吸性碱中毒 C.代谢性酸中毒 D.代谢性碱中毒 E.呼吸性碱中毒合并代谢性酸中毒 93.矿井塌陷引起通风不良可引起酸碱平衡紊乱的类型是: A.呼吸性碱中毒 B.呼吸性酸中毒 C.代谢性酸中毒 D.代谢性碱中毒 E.代谢性酸中毒合并呼吸性碱中毒 94.慢性呼吸性酸中毒时,机体代偿的主要方式是: A.细胞外液缓冲 B.呼吸代偿 C.细胞内缓冲 D.肾脏代偿 E.骨骼代偿 95.下列哪一项不是呼吸性酸中毒病因: A.呼吸中枢及呼吸肌麻痹 B.气道阻塞 C.肺部疾患通气障碍 D.肺泡弥散障碍 E.通风不良 96.慢性呼吸性酸中毒时,机体代偿的主要方式是: A.细胞外液缓冲 B.呼吸代偿 C.细胞内缓冲 D.肾脏代偿 E.骨骼代偿 97.酸中毒对心肌收缩性的影响是: A.先增强后减弱 B.先减弱后增强 C.减弱 D.增强 E.不变

[X型题] 98.阴离子间隙增大型正常血氯性酸中毒常见于: A.酮症酸中毒患者 B.晚期慢性肾功能衰竭患者 C.乳酸酸中毒患者 D.水杨酸中毒患者 E.呕吐患者 99.呼吸性碱中毒时机体的代谢调节包括: A.细胞内外离子交换代偿增强,细胞外液氢离子升高,钾离子下降 B.细胞内外离子交换代偿增强,细胞外液氢离子钾离子均升高 C.经肾脏代偿调节,肾小管上皮细胞排氢离子减少 D.呼吸运动加快,二氧化碳排出过多 E.呼吸运动减弱二氧化碳排出减少 100. 呼吸性酸中毒初期表现为:
A.血浆中H2CO3浓度原发性降低
B.血浆中H2CO3浓度原发性增高
C.PaCO2>6.25kPa,AB<SB
D.PaCO2>6.25kPa, AB>SB
E. PaCO2<6.25kPa, AB>SB 101. 代谢性酸中毒时,对中枢神经系统危害较大的因素是:
A.pH下降 B.高钾血症 C.CO2升高
D.r- 氨基丁酸增多 E. r- 氨基丁酸减少 102.低氯性碱中毒常见于: A.使用过多的速尿、利尿酸等利尿剂 B.原发性醛固酮增多症 C.Cushin氏综合症 D.碳酸氢盐摄入过多 E.纠正酸中毒时,乳酸钠溶液输注过量 103.对氯反应性碱中毒时,下列哪些叙述是正确的: A.补充生理盐水可纠正低氯性代谢性的碱中毒 B.补充生理盐水后不能纠正低氯性代谢性碱中毒 C.速尿利尿剂应用过多可引起低氯性代谢性碱中毒 D.严重呕吐可引起低氯性代谢性碱中毒 E.碱性液体输注过量 104.阴离子间隙(AG)正常型高氯性酸中毒见于: A.近端肾小管性酸中毒 B.急性重症性肾功能衰竭 C.慢性肾功能衰竭早期 D.严重腹泻 E.急性呼吸道阻塞 105.高热时可引起酸碱平衡紊乱的类型有: A.代谢性酸中毒合并呼吸性酸中毒 B.代谢性酸中毒合并呼吸性碱中毒 C.代谢性碱中毒合并呼吸性碱中毒 D.代谢性酸中毒 E.代谢性碱中毒

[B型题] A.血液中缓冲系统的作用 B.肺的调节作用 C.肾的调节作用 D.组织细胞的缓冲作用 E.中枢神经的调节作用 106.对排出挥发性酸性物质具有重要作用的是: A.缓冲能力最持久 B.缓冲能力强,但有一定限制 C.缓冲作用发生最快 D.调节能力最强 E.缓冲能力最小,调节能力也小 107.肺的调节作用: 108.细胞的缓冲作用: 109.肾的调节作用: 110.骨骼的缓冲: 111.血液的缓冲系统: A.代谢性酸中毒 B.代谢性碱中毒 C.呼吸性酸中毒 D.呼吸性碱中毒 E.酸碱平衡正常 112. HCO3-原发性减少见于: 113. HCO3-原发性增加见于: 114. HCO3-继发性增加见于: A.代谢性酸中毒 B.代谢性碱中毒 C.呼吸性酸中毒 D.呼吸性碱中毒 E.酸碱平衡正常 115.碳酸根离子原发性减少见于: 116.碳酸根离子原发性增加: 117.碳酸根离子继发性增加: A.呼吸系统代偿 B.细胞内、外液缓冲作用 C.肾脏代偿 D.骨骼缓冲作用 E.心血管代偿作用 118.急性呼吸性酸中毒时机体对酸碱平衡紊乱的主要代偿方式是: 119.慢性呼吸性酸中毒时机体对酸碱平衡紊乱的主要代偿方式是: 120.引起代谢性酸中毒合并代谢性碱中毒: A.心跳,呼吸骤停 B.慢性肺源性心脏病 C.急性胃肠炎剧烈加腹泻 D.发热呕吐 121.引起代谢性酸中毒合并呼吸性碱中毒:

[名词解释] 122.代谢性酸中毒 123.呼吸性碱中毒 124.二氧化碳结合力 125.标准碳酸氢盐(SB) 126.实际碳酸氢盐(AB) 127.缓冲碱(BB) 128.碱剩余(BE) 129.阴离子间隙(AG)

[问答题] 130.叙述代谢性酸中毒时,机体有哪几种代偿性调节?哪种代偿方式出现最早?哪种代偿方式作用最持久?详细叙述这两种代偿方式。 131.详细叙述颅脑损伤后易引起哪种酸碱平衡紊乱?其发生机制是什么? 132.叙述酸中毒时对机体危害最大的是哪两个方面。 133.何谓"脱水热",简述其发生机制? 134.为什么低渗性脱水病人容易休克? 135. 慢性阻塞性肺气肿病人,在合并中毒性休克四天后,突然出现呼吸心跳骤停。经及时抢救后病人呼吸心跳恢复,血生化检验提示:PH5.2。[HCO-3]=16mEq%/L,PaCO2>2kpa AG>mEq%/L 。请分析此时体内酸碱平衡所处的状况。 136.举例说明机体内存在着的酸碱共轭体系: NaHCO/HCO NaHPO/NaHPO 137. 慢性阻塞性肺气肿病人,在合并中毒性休克四天后,突然出现呼吸心跳骤停。经及时抢救后病人呼吸心跳恢复,血生化检验提示:PH5.2。[HCO-3]=16mEq%/L,PaCO2>2kpa AG>mEq%/L 。请分析此时体内酸碱平衡所处的状况。 138.酸碱紊乱时代偿出现较迟,维持时间较长的是:

[填空题] 139.乳酸性酸中毒时,反映酸碱平衡紊乱的生化指标变化特征是PH________[HCO3]_________,血氯__________,AG___________. 140.引起呼吸性酸中毒的原因包括________________或 ___________________. 141.碱中毒时,血红蛋白氧离曲线_____,血氧含量,血氧饱和度_____,而组织的供氧量是_______的,因为_____________________________. 142.在排除普通膳食条件下摄取酸物质的因素,人体内酸物质来源主要包括_______________和__________________。 143.血浆缓冲系统包括_________,________,__, 而细胞外液的PH主要取决于_______________________的比值 144.红细胞的缓冲系统包括有 _______,_________,________。_________其中以__________最为重要。 145. 已知氢离子在远、近曲小管内随尿排出的机制是有区别的,远曲小管在重吸收__________的同时,H+是随H2CO3而不是象在近曲小管那样随_________而排出体外的。 146.肺在酸碱平衡的调节作用是通过______________来调节血浆_________的变化。 147.标准碳酸氢盐是指全血标本在标准条件下,即在温度___________氧饱和度__________________和_________________平衡后,_________________. 148.在一个化学反应中,能释放_________的化学物质称为酸,例如______ 和________;能接受_______的化学物质称为碱,例如_____和_________。

参考答案

[A型题]

|1.A |2.C |3.D |
|109.A |110.E |111.C |
|11 |113.B |114.C |
|2.A | | |
|115.A |116.B |117.C |
|118.B |119.C |120.C |
|121.D | | | [名词解释] 122.因通气过度引起的血浆H2CO3浓度原发性减少,PaCO下降和AB<SB
123.指血浆HCO-中的CO2含量,其正常值为23~31mmol/L.

124. 是指全血在标准条件下(38摄氏温度,100%的血红蛋白饱和度,PCO为5.32kPa时测得的血浆中的HCO-浓度,正常范围是22-27mmol/L 125.指血标本与空气隔绝下,实际的PCO和血氧饱和度条件下,测得的血浆HCO-浓度,正常范围是22-27mmol/L 126.是血液中一切具有缓冲作用的负离子的总和,正常范围是45-55mmol/L 127.在温度为38摄氏温度,PCO 5.32kPa.Hb15Og/L和血氧饱和度为100%时,用酸或碱将1L全血或血浆的PH滴至到PH7.40时所用的酸或碱的量用mmol/L表示,正常范围为0±3mEq/L 128.指血清中未测定的阴离子量减去未测定的阳离子量的差值。即AG=UA-UC正常范围为mmol/L 129. 指血浆HCO-浓度原发性减少,血浆PH SB AB BB和CO C P均降低。 [问答题] 130. 代谢性酸中毒时有血液的缓冲,肺,肾,细胞内及骨骼肌等五种代偿方式,其中以肺代偿出现的最早,肾脏代偿方式作用最持久。 [H+] 刺激外周化学感受器→呼吸中枢 →呼吸运动加深加快→[H2CO3]↓ 使[H2CO3]/[NaHCO3]=1:20 刺激肾小管上皮细胞 中碳酸酐酶活性→ 肾排氢离子↑回收NaHCO3↑ →使[NaHCO3] ------- [H2CO3] 的比值维持在20:1
131. 颅脑损伤后极易引起呼吸性酸中毒 颅脑受损→易抑制呼吸中枢的兴奋性→呼吸运动↓通气不足→CO2排出↓→CO潴留CO体内↑ →[CO+H+→H2CO↑(原发性增高)AB>SB[PaCO>6.25Pa、CO C P↑ 再抑制呼吸中枢兴奋性,引起通气不足的恶性循环 132.高渗性脱水严重的病例,尤其体温调节功能发育尚未完全的婴幼儿,易出现体温升高。 发生机制:1.严重脱水引起循环血量减少,通过RAA系统和交感神经系统使皮肤血管收缩,不显性排汗减少,导致散热障碍,2.细胞外液渗透压显著升高,细胞内水分外移,细胞内脱水,体温调节中枢的热敏神经无功能障碍,而使体温调定点上移,结果导致体温升高. 133.①低渗性脱水病人血浆渗透压降低,无口渴感,饮水少 134.②血浆渗透压低,ADH分泌减少,尿量不减少 135.③细胞外液渗透压低于细胞内液,细胞外液向细胞内转移,使细胞外液进一步减少

[填空题] 139.降低;降低;正常 增大 140.①二氧化碳排出障碍;②二氧化碳吸入过多 141.①左移;②升高;③下降;④氧合血红蛋白不易释放氧气 142. ①机体新陈代谢时产生能量的同时释放出的氢离子 ②物质分解代谢过程中产生的有机酸
143. NaHCO3 NaHPO4 Na-Pr [NaHCO3] ----------- ----------- 和 ------- ------------- H2CO3 NaH2PO4 H-Pr [H2CO3]
144. KHCO3 K2HPO4 K-Hb K-HbO2 --------- ---------- ------- 和 ---------Hb与HbO2缓冲系统 H2CO3 KH2PO4 H-Hb H-HbO2
145. NaHCO3, H2O 146.频率和幅度; HCO浓度
147. ①温度为38摄氏温度; ②氧饱和度为100%; ③PCO2为5.32kPa ④血浆中的HCO3-浓度
148. H+;HCl ;H2SO4;H+ ;OH- ;SO42-

难题解析

试题 某肺心病患者,血气分析及电解质测定结果如下:PH 7.26,PaCO2 85.8mmHg, HCO3- 37.8mmol/人 CI- 90mmol/人 Na+ 140mmol/人 下列诊断中最有可能是哪一种: A.呼吸性酸中毒 B.代谢性酸中毒 C.呼吸性酸中毒合并代谢性酸中毒 D.呼吸性酸中毒合并代谢性碱中毒 E.呼吸性碱中毒 答案:C
解析:本病例PaCO2明显高于正常,结合患者有肺心病,表明存在呼吸性酸中毒。该病例AG值为140-(90+37.8)=12.2mmol/L,在正常范围内。预测HCO3-=0.4×(85.8-40)±3=18.3±mmol/L,HCO3-=24+HCO3=42.3±3=39.3~45.3mmol/L,而实测HCO3-为37.8mmol/L,低于预测值范围的最低值,表明还同时存在着可使HCO3-降低的代谢性酸中毒,故可诊断呼吸性酸中毒合并代谢性酸中毒,由于同时存在着两种酸中毒,所以pH明显降低。

试题 血气分析测定结果为PaCO2降低,同时伴有HCO3-升高,可诊断为: A.呼吸性酸中毒
B.代谢性酸中毒
C.呼吸性碱中毒
D.代谢性碱中毒
E.呼吸性碱中毒合并代谢性碱中毒
答案:E
解析:在单纯酸碱失衡中,PaCO2降低,HCO3也降低,而以上测定中,PaCO2降低而HCO3-反升高,表明决不可能是单纯性酸碱失衡。患者的PaCO2下降可判断存在呼吸性碱中毒,患者HCO3-升高,说明还合并代谢性碱中毒,即患有呼吸性碱中毒合并代谢性碱中毒,这种病人肯定为失代偿,pH将很高。

试题 碱中毒时出现神经肌肉应激性亢进,手足抽搐的主要原因是:
A.血清K+减少 B.血清CI- 减少 C.血清Ca2+减少
D.血清Na+减少 E.血清Mg2+减少
答案:C
解析:碱中毒时,血pH升高,血清钙中结合钙浓度升高,而游离钙浓度减少,出现神经肌肉应激性亢进,手足抽搐等症状。 试题 某慢性肾功能不全患者,因上腹部不适呕吐而急诊入院,血气分析结果:PH 7.39 PaCO2 43.8mmHg HCO3- 26.6mmol/人 Na+ 142mmol/人 Cl- 96.5mmol/人诊断属哪一种酸碱失衡:
A.AG增高性代谢性酸中毒
B.AG正常性代谢性酸中毒
C.AG增高性代谢性酸中毒合并代谢性碱中毒
D.AG正常性代谢性酸中毒合并代谢性碱中毒
E.AG增高性代谢性酸中毒合并呼吸性酸中毒
答案:C
解析:本病例pH 、HCO3-和PaCO2均在正常范围内,饭店无明显的酸碱失衡,但AG=Na+-(CL-+HCO3-)=142-(96.5+26.2)=18.3mmol/L,比正常12.0mmol/L高7.3mmol/L,提示有高AG代谢性酸中毒.如属单纯性高AG代谢性酸中毒,AG升高应有相等mmol/L的HCO3-下降.但实测HCO3-为26.2mmol/L,反高于均数24mmol/L,加上患者有呕吐,其HCO3-可原发性升高而血氯降低(96.5mmol/L),提示合并代谢性碱中毒,所以本病例应诊断为高AG性代谢性酸中毒合并代谢性碱中毒。如不计算AG,可误诊为血气指标正常。

试题 下列哪一项混合性酸碱失衡不可能出现: A.代谢性酸中毒合并代谢性碱中毒 B.呼吸性酸中毒合并呼吸性碱中毒 C.代谢性酸中毒合并呼吸性碱中毒 D.代谢性酸中毒合并呼吸性酸中毒 E.代谢性碱中毒合并呼吸性碱中毒
答案:B
解析:两种酸碱紊乱并存的情况主要有下列六种可能:(1)呼吸性酸中毒合并代谢性酸中毒;(2)呼吸性酸中毒合并代谢性碱中毒;(3)呼吸性碱中毒合并代谢性酸中毒;(4)呼吸性碱中毒合并代谢性碱中毒;(5)代谢性酸中毒合并代谢性碱中毒(主要指高AG代谢性酸中毒合并代谢性碱中毒);(6)高AG代谢性酸中毒合并正常AG代谢性酸中毒。但呼吸性酸中毒和呼吸性碱中毒,不可能同时存在,因为PaCO2不可能过高和过低同时存在,即肺通气不可能过度和不足同时并存。

试题 AG增高提示机体可发生: A.高氯血性代谢性酸中毒 B.正氯血性代谢性酸中毒 C.代谢性碱中毒 D.呼吸性酸中毒 E.呼吸性碱中毒
答案:B
解析:负离子间隙(AG)是指从血浆中未测得的负离子量,减去未测定的正离子量的差值。AG增高反映了高AG的代谢性酸中毒,即正常氯血性代谢性酸中毒。

试题 溃疡病并发幽门梗阻患者,因反复呕吐入院,血气分析结果如下:
PH>7.48,PaCO26.4kPa(48mmHg),HCO-336mmol/L该病人酸碱失衡的
类型是:
A.代谢性酸中毒
B.代谢性碱中毒
C.呼吸性酸中毒
D.呼吸性碱中毒
E.混合性酸碱中毒
答案:A
解析:根据病史及血气分析结果,病人原发酸碱失衡是HCO3-过多,而导致pH增高,似属代谢性碱中毒。代谢性碱中毒是否并发其他酸碱紊乱,可从预测代偿公式判断:

试题 阴离子间隙(AG)增高的代谢性酸中毒常见于: A.腹泻 B.使用乙酰唑胺利尿 C.糖尿病 D.肾小管性酸中毒 E.大量输入生理盐水
答案:C
解析:AG增高是指未测定的阴离子酸根在体内积蓄过多,主要见于乳酸性酸中毒,酮症性酸中毒及严重肾功能衰竭所致的酸中毒。糖尿病常可导致酮血症,是AG增高的代谢性酸中毒常见的病因,而上述其他原因,均不引起AG增高。

试题 慢性呼吸性酸中毒时,机体代偿的主要方式是: A.细胞外液缓冲 B.呼吸代偿 C.细胞内缓冲 D.肾脏代偿 E.骨骼代偿
答案:B
解析;由于呼吸性酸中毒的原因是呼吸障碍,所以呼吸系统往往不能发挥代偿作用。血浆的非碳酸氢盐缓冲系统对增高的碳酸有缓冲作用,并使HCO3-略有增加,但增加很有限,细胞内外离子交换及细胞内缓冲也很有限。主要的代偿措施为肾脏代偿,表现在肾产氨排H+和NaHCO3重吸收显著增多,从而使大量H+随尿排出,而血浆HCO3-有较多升高,使HCO3-/H2CO3比值接近正常,但肾脏代偿较慢,需要3~5天后才发挥最大代偿效应。所以在慢性呼吸性酸中毒时,肾脏代偿是主要的代偿方

试题 下列哪一项不是呼吸性酸中毒病因: A.呼吸中枢及呼吸肌麻痹 B.气道阻塞 C.肺部疾患通气障碍 D.肺泡弥散障碍 E.通风不良
答案;D
解析:因CO2弥散能力很强(比氧约大20倍),肺泡气体弥散障碍一般不会导致CO2蓄积产生,只有通气障碍及通风不良造成PaCO2>45mmHg(6.0kPa)时,才产生呼吸性酸中毒。
式。

Similar Documents

Free Essay

Medical

...Medical Assistant: Medical assistant possess good critical thinking skills and are able to pay attention to details. Empathy, flexibility, self-control, integrity, willingness to learn is other important traits of a medical assistant. Additionally they must have a neat professional appearance, good communication skills. Most medical assistants have both clinical and clerical responsibilities. Clinical functions vary depending on the scope of duties permitted by the Laws of each state. Their responsibilities may include helping the physician by obtaining the patient’s medical history; taking and recording the patient’s height and weight; obtaining and recording vital signs, such as pulse, temperature, respiration, and blood pressure; preparing the patient for examination and/or treatment; drawing blood; assisting in examining And/or treating the patient; performing routine laboratory tests and EKGs; Applying dressings; instructing the patient in preparation for x-rays and laboratory examinations; preparing and administering medications as directed by a physician. The clerical, or administrative, responsibilities that a medical assistant may be expected to perform include scheduling and receiving patients; transcribing and maintaining medical records; procedural and diagnostic coding; typing and taking dictation; arranging for hospital admissions and laboratory procedures for patients; and handling telephone calls, correspondence, reports, insurance matters, office...

Words: 1305 - Pages: 6

Premium Essay

Medical

...be found? From this I can conclude that smaller offices that use the paper filling system instead of electronic more than likely have less holding space for the medical records while medium and large facilities may have more holding stations, but now usually have less than a small facility does because they more electronic records than paper. Question seven, if paper records: Is there a need to chart the circulation of files from one location to another, so that your staff knows where files are kept? What I can conclude form this question is that no matter what size facility the staff is working in, there should be some sort of organization process or filing system, either alphabetical or numerical order of the patient’s medical records and they should not have to be circulated from one location to the next so that each staff member knows where it is located. In question nine, what can cause the biggest problem for records management if it isn’t done right? I also can conclude from this question looking at the whole picture will all the different size facilities. Simply in any facility size if the records management is not done correctly, it can cause confusing and a hectic work environment when having to look for patient’s medical records. No matter the size of the facility no having a proper routine for the medical records to be filed properly can...

Words: 757 - Pages: 4

Premium Essay

Medical

...Maria Hernandez Mod 170 Ms. Lily Anesthesiology An anesthesiologist is a medical doctor who cares for a patient before, during and immediately following a surgical or medical procedure by administering the appropriate anesthesia and monitoring the patient for reactions and complications, and to ensure comfort and manage pain. Some of the primary responsibilities of an anesthesiologist include examining the patient to determine the type of anesthetic needed, communicating all relevant information to the appropriate medical practitioners, and administering local, intravenous, or spinal anesthetic to the patient. Anesthesiologists meet with the patient prior to the surgical procedure to evaluate their condition and to review their medical history, they will explain the procedure to the patient so that they know what to expect. During surgery, an anesthesiologist carefully monitors the patient's vital signs—including heart rate and rhythm, blood pressure, breathing, and kidney function—and adjusts anesthetics as needed. When surgery is finished, the recovery phase begins. The anesthesiologist administers medications to reverse the effects of the anesthetic, returning the patient to consciousness if a general anesthetic has been used. After surgery, patients are moved to a recovery room, where the anesthesiologist is still responsible for the patient's vital functions. In the recovery room, nurses and other specially trained staff closely monitor the patient under the supervision...

Words: 1328 - Pages: 6

Premium Essay

Medical

...0 3 0 Electronic Health Records in the Physician Office CHAPTER OUTLINE Patient Flow in the Physician Practice Step 1. Pre-Visit: Appointment Scheduling and Information Collection Step 2. Patient Check-in and Payment Collection Step 3. Rooming and Measuring Vital Signs Patient Examination and Documentation Step 4. Patient Checkout Step 5. Post-Visit: Coding and Billing Post-Visit: Reviewing Test Results Coding and Reimbursement in Electronic Health Records Computer-Assisted Coding Clinical Tools in the Electronic Health Record Decision-Support Tools Tracking and Monitoring Patient Care Screening for Illness or Disease Identifying at-Risk Patients Managing Patients with Chronic Diseases Improving the Quality and Safety of Patient Care with Evidence-Based Guidelines E-Prescribing and Electronic Health Records Keeping Current with Electronic Drug Databases Increasing Prescription Safety Saving Time and Money LEARNING OUTCOMES After completing this chapter, you will be able to define key terms and: 1. 2. 3. 4. 5. 6. 7. 8. 9. List the five steps of the office visit workflow in a physician office. Discuss the advantages of pre-visit scheduling and information collection for patients and office staff. Describe the process of electronic check-in. Explain how electronic health records make documenting patient exams more efficient. Explain what occurs during patient checkout. Explain what two events take place during the post-visit step of the...

Words: 12974 - Pages: 52

Premium Essay

Medical Error's

...Medical Error’s TUI University BHS-499 Senior Capstone Project Module 5 SLP Professor: Medical Error’s I. Introduction: Background and Context of Medical Error’s.  Preventable medical errors kill more Americans than diabetes, influenza and Alzheimer’s; and if tracked separately, would be the sixth-leading cause of death in the United States. The National Academy of Sciences, Institute of Medicine (IOM) has estimated that 98,000 Americans die each year as a result of preventable medical errors.  Medical Error’s  II. Importance, Relevance/Extent of Medical Error’s.  There are many types of medical error and they can be classified from minor to major depending on the result of the error.  According to the Agency of Healthcare Research and Quality (AHRQ), in November of 1999 the Institute of Medicine (IOM) released a report estimating that as many as 48,000-98,000 patients died as a direct result of medical error in the hospital each year. Patients are always at risk and medical errors may result in: (AHRQ) • A patient inadvertently given the wrong medicine. • A clinician misreading the results of a test. • An elderly woman with ambiguous symptoms (shortness of breath, abdominal pain, and dizziness) whose heart attack is not diagnosed by emergency room staff. Medical Error’s  III. Cause of Medical Error’s.  Some or most of the hospitals around the world are under-funded and using limited funding efficiently could be very difficult task.  Limited funding...

Words: 1004 - Pages: 5

Premium Essay

Medical Tourism

...In the interview to Sity Suhana Elsa Abdul Majid, Senior Executive Medical Tourism & Business Development of Institut Jantung Negara (IJN), basically IJN is private hospital that is under Ministry Finance of Malaysia. Its objective of existence is medical service to patient, training to doctor and research and development in heart. Just last three years IJN setup their international patient office. This is to promote medical tourism and offer many service to help international patient. In order to market IJN as destination, one of the way IJN do is setup a medical office or in other word representative at overseas. IJN target ASEAN countries because increase in population such as in Indonesia, Cambodia and also Myanmar. Besides that, IJN also promote by Malaysia Healthcare Travel Council (MHTC) to international patient to come to IJN. MHTC is organization that responsible to promote Malaysia health tourism. IJN also do own marketing by mouth to mouth marketing by the international doctor that come to IJN do their training. IJN also offer wide range of services not just cardiologic disease surgery but angiogram and dietician. According to her, roughly around 80-70 Indonesian international patient come to IJN monthly and overall about 150-250 international patient come to IJN. She also explains that international patient especially Indonesian come to IJN to do Coronary Angiogram. It is a special x-ray of the heart arteries to see if they are narrowed or block. It’s a basic procedure...

Words: 1138 - Pages: 5

Premium Essay

Medical Terminology

...In Section 4, you will proofread the Progress Report listed below. Next, you will identify the 15 mistakes that are listed in the report. The mistakes could be misspellings, incorrect abbreviations or misuse of a medical term. Please list them in the chart below under the heading “Medical Terminology Error.” After you have listed the errors, you will need to identify the correct term or abbreviation. Please list them in the chart below under the heading “Correct Term.” • PROGRESS NOTE • CHIEF COMPLAINT: Severe pain between the shoulder blades, shortness of breathe, nausea for the past 3 hours. • • PRESENT ILLNESS: Darelen Denton is a 62-year-old woman who presented to the emergency department via ambulance. In transport, patient received O2 at 4 liters via nasal cannula, baseline EKG, Normal Saline IV started in left hand, 325 mg aspirin by mouth (po). Patient complained she was short of breath and experiencing severe pain between her shoulder blades. She stated that she has been feeling nasuseated for the past 3 hours. She states she has a history of stable angina and is currently taking medication as needed. She states she did not take the nitroglycerin because she was not experiencing chest pain, just back pain. She states that her last check-up with the Pulmonologist showed that her EKG did not show any changes since her last visit. She denies episodes of syncope. The patient does report that she tripped over something on the floor, which resulted in her falling...

Words: 498 - Pages: 2

Free Essay

Medical Assistant

...Jocelinn Pineda 06/17/2013 Chapter 6 Exercise 6-1 The EHR in this physicians practice contains many functions. Look at the functions above. What function(s) do you think a medical assistant would use and why? Medical assistants might use the practice view icon to search for their email in case they are unable to contact a patient by phone. Patient view icon may be another function medical assistance may use for the administrative data of a patient. Exercise 6-2 Why is it important to use more than one attribute when searching for a patient, especially in addition to a first and/or last name? It’s important because the search using a first and/or last name can bring up two or more patient’s with the same names and if you use a birth date in the search a more accurate result of the patient that you are looking for can come up. Exercise 6-3 Briefly describe administrative, clinical, and billing data and state whether the screen above contains any such data. Administrative data is the information of the patient such as full name, date of birth, address, social security number, and telephone numbers. Clinical data is the patients health information. And billing data includes financial information about a patient; the screen above does contain administrative data. Exercise 6-4 The EHRS has the ability to capture data using a drop-down menu. What are the advantages and disadvantages of using a drop-down menu? An advantage of using a drop-down menu is that it makes...

Words: 514 - Pages: 3

Free Essay

Medical Malpractice

...Brian Ardizzoni Michael Neil English 1301, Composition 1 25 November 2012 Medical Malpractice For nearly forty years, tort reform constantly becomes an increasingly controversial issue affecting the medical community, the legal community and most of all, the victims of some very unfortunate accidents. Tort reform refers to laws passed on a state-by-state basis which place limits or caps on the type or amount of damages awarded in personal injury lawsuits. Those who advocate medical malpractice tort reform believe limitations should be set on the amount of damages a plaintiff or injured party can be rewarded by the court. These advocates usually include medical professionals and insurance companies. Their argument is that too many frivolous lawsuits lead to high malpractice insurance, the increasing cost of medical care and a burden on the taxpayers whose tax dollars absorb the extravagant litigation costs for these claims. They believe doctors will eventually be unable to practice medicine due to costly malpractice insurance premiums which may leave many Americans unable to obtain much-needed healthcare. In the past, as the rate of malpractice suits began to grow, so did the rate of malpractice insurance. This ended up having a dire impact on the medical profession. For one thing, many qualified doctors ended up leaving their practices and focusing more on preventative medicine. In other words, they...

Words: 3268 - Pages: 14

Free Essay

Medical Marijuana

...Medical Marijuana If a substance can make someone who is ill feel better, why keep it from him or her? On the surface this sounds right. People who advocate making marijuana legal for medical purposes take this approach. What could it hurt? A closer look reveals that marijuana should not be legalized for medical use, because young people are given mixed signals about drugs, other drugs can be used that are easier to regulate, and there are more harmful side effects. Marijuana is one of the most abused drugs in America today. It is estimated that close to four million Americans regularly use marijuana. It is often one of the first illegal drugs that young people experiment with (Gassett2). Legalization for medical purposes would send a mixed signal to our youth. Young people are taught at a very early age about the harmful effects and the abusive potential of marijuana. If at the same time, they are told that marijuana is medically benevolent, the result could be confusion. Andrea Barthwell, former deputy Director of the office of National Drug Policy said this in 2004, “Children entering drug abuse treatment routinely report that they heard ‘pot is medicine’ and, therefore, believed to be good for them.” (19). At a time when recreational drug use is at an all time high, it would not be wise to legalize marijuana for medical purposes. The war on drugs begins with young people. If they are confused about whether or not a drug like marijuana is harmful, the battle...

Words: 2175 - Pages: 9

Free Essay

Medical Assitant

...Medical Assisting Brenda Simpson Kaplan University, Watarai, Hiroki Three years ago my mother passed away due to a heart attack. Within in the same year one of my sisters was diagnosed with terminal adrenal cancer known as Paraganglioma. She passed away nine months later after finding out it was not curable. This how I really found the chance to see how good ethics played a role in the care of both family members. I was how amazed how awesome the Dr’s. And the healthcare team played together until their last days and took their last breath. I was able to see the duties of the doctors, nurses, and the medical assistants. I knew right then I wanted to be able to make a lasting impression in someone’s life in a positive way. Nevertheless, I did my research and personality test, which led to this career choice. Medical assisting was best fitted for me. The overview of the profession is what made it so interesting to me. All of the duties that were held for my mother and sister made me to want to pursue this career even more. The duties include, taking medical histories and recording vital signs, explaining treatment procedures to patients, preparing for examinations, and assisting physicians during examinations. (Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2010-11 Edition, Oct 18, 2010) These are just some of the duties, which were named in above. Further duties include, telephone prescriptions, change dressings on...

Words: 754 - Pages: 4

Free Essay

Medical Reports

...Associate Level Material Medical Report This assignment is for you to create a screening tool for potential hires in your health care facility. As the health care administrator, you would want to ensure that your future employees have a strong understanding of medical reports and medical terminology. You are writing these reports for the applicants to read, interpret, and answer a set of questions you have developed. Refer to the samples of medical records reports on pages (142-144, 196, & 261-263) of the textbook. Each medical record should be completed and contain two questions you would ask of the potential hires. The following suggestions will help you get started: • Sometimes it is easier to start at the end. Think of the diagnosis the patient will receive. If you know what the end diagnosis will be, it makes it easy to know what symptoms, signs, and diagnostic methods would be used to achieve that diagnosis. • For the History of Present Illness, consider what questions the physician might ask the patient about his or her chief complaint and symptoms and then chart that in this section. This section serves as an account of what the patient would report, based on their symptoms. Remember, symptoms are subjective, in that they are conditions experienced by the patient, and are therefore included in the patient history. • For Past Medical History, document anything the patient may indicate in terms of past medical conditions that would be relevant to his or...

Words: 671 - Pages: 3

Free Essay

Medical Transcriptionist

...Medical Transcriptionist Jessie Warren Introduction to Health Services & Info Systems Professor Nettles HIT 120 I have chosen to go back to school to help my family financially in the long run. I chose the medical field as it is the fastest growing job market. I specifically chose the career as a medical transcriptionist. Granted, according to the Bureau of Labor Statistics 2012-2013 the employment of medical transcriptionists is expected to grow 6% from 2010 to 2020, slower than the average for all occupations. That fact doesn’t detour me because I chose this field due to research, that this is a job I can do from home. With my two boys, this seemed like a great fit. I can work when they nap or go to school and when my husband is home. Therefore I am supplying not only a second income in the home to achieve financial stability, but I am also cutting costs by not having to pay for daycare. The HIM career map 2013 states that the average pay is $36,941. The median pay as of May 2010 was $32,900/year according to the Bureau of Labor Statistics 2012-2013. Account in the fact that I will be saving a minimum of $14,400/year on daycare costs, it is a wise decision. Medical transcriptionists listen to dictations from the health professional. They take the dictations and they turn it into results, reports, letters and documents. They are able to edit the drafts that are prepared checking for both accuracy and consistency. As the Bureau of Labor Statistics 2012-2013 states...

Words: 909 - Pages: 4

Premium Essay

Medical Marijuana

...Week 9 Research Paper Medical Marijuana COM/156 August 11, 2013 Medical Marijuana ~“Marijuana is the finest anti-nausea medication known to science, and our leaders have lied about this consistently. [Arresting people for] medical marijuana is the most hideous example of government interference in the private lives of individuals. It’s an outrage within an outrage within an outrage”~ ~Peter McWilliams~ Author and Advocate for Medical Marijuana Medical Marijuana has found its place once again as the medical plant that is recognized for its healing potential and properties. How the Government has suppressed its positive potential and healing powers for over 25 years. With the help frommany patients, loved ones, research departments and advocate groups, to get the Government’s attention to see and understand that the terminally ill, and the sick should not be treated as common criminals. They are only trying to find some peace and serenity, in their last days. The struggle and fight that has been going on for the last 25 years against the Government. The people were finally heard, with the legalization of Medical Marijuana. The Government wants to regulate everything for their best interest, the positive effect of decriminalizing marijuana for the terminally ill, and the positive economic benefits for our community. Cannabis Sativa, Marijuana, Weed, Herb, Mary Jane these are just a few names that this little 5 leaf plant goes by. How could this...

Words: 3054 - Pages: 13

Premium Essay

Medical Ganja

...Medical Marijuana In 1972, the United States put marijuana in Schedule I of the Controlled Substances Act. They believed it had no probable medical use. Since that time 23 states as well as Washington DC have legalizes the use of medical marijuana. The legalization of Marijuana has been an ongoing topic for the past couple of years in the United States. Several different opinions have been made but ultimately it comes down to people who are pro marijuana and those who oppose it. Some argue that medical marijuana is safe and effective for several different diseases such as cancer, AIDS, glaucoma etc. Although marijuana use has been around for ages and probably has done more to help then hurt many people do not want to see it legalized. People who are opposed to the legalization fear that it is dangerous and leads to harder drug use. This argument is has been presented quite often. Health classroom across the United States teach children that marijuana is a gateway drug. Some of the other reasons for not legalizing marijuana are that if legalized for medicinal use recreational use will spike, especially among teens and adolescents. However, studies have proven that inaccurate. According to a study by the National bureau of Economic Research concluded that there was no significant increase in pot use by teenagers who lived in states where it was legalized. I personally believe that medical marijuana should be legalized. It seems to have helped more than it has hurt. I honestly...

Words: 498 - Pages: 2