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Indicate the type of ABS disorder if pH = 7.21

Question 93Answer

1.
compensated


2.
decompensated


3.
alkalosis


4.
acidosis


5.
subcompensated

If the pH is 7.21, this indicates acidemia, as the normal blood pH range is approximately 7.35 to 7.45. Therefore, the type of acid-base state disorder indicated by a pH of 7.21 is:

**4. Acidosis**

### Additional Considerations:
- The terms "compensated," "decompensated," and "subcompensated" typically refer to the body's response to the acidosis or alkalosis:
  - **Compensated**: The body has adjusted to maintain a normal pH despite an underlying acid-base disorder.
  - **Decompensated**: The body's regulatory mechanisms are insufficient to normalize the pH, indicating a more severe disruption.
  - **Subcompensated**: Indicates some attempt at compensation, but the imbalance is significant enough that normal pH is not achieved.

Given that the pH of 7.21 is below the normal range, and without more information to assess compensation levels, the best choice is:

**4. Acidosis**.

Choose the incorrect statements:

Question 94Answer

1.
In the process of life of the organism both acidic and alkaline metabolic products are formed, and the first are formed almost 20 times more than the second


2.
Acid-base balance is a state in which oxygen is not available in sufficient amounts at the tissue level to maintain adequate homeostasis


3.
In the process of life of the organism both alkaline and acidic metabolic products are formed, and the first are formed almost 20 times more than the second


4.
The pH indicator is a negative decimal logarithm of the hydrogen ion concentration in a solution


5.
Maintenance of the body's acid-base balance is provided by buffer systems and physiological mechanisms of compensation

The incorrect statements among the options provided are:

2. **Acid-base balance is a state in which oxygen is not available in sufficient amounts at the tissue level to maintain adequate homeostasis.**
   - This statement is incorrect because acid-base balance refers to the regulation of the hydrogen ion concentration (pH) in the body, and while oxygen can play a role in cellular metabolism (for instance, contributing to acidosis in cases of hypoxia), the term "acid-base balance" does not directly relate to the availability of oxygen. Acid-base balance is more about the equilibrium between acids and bases in the body.

3. **In the process of life of the organism both alkaline and acidic metabolic products are formed, and the first are formed almost 20 times more than the second.**
   - This statement is also incorrect because typically, acidic metabolic products (like carbonic acid from CO2, lactic acid from anaerobic metabolism, etc.) are formed in much greater quantities than alkaline products. 

### The correct statements are:

1. **In the process of life of the organism, both acidic and alkaline metabolic products are formed, and the first are formed almost 20 times more than the second.**
   - This statement is correct and aligns with metabolic processes.

4. **The pH indicator is a negative decimal logarithm of the hydrogen ion concentration in a solution.**
   - This statement is also correct; pH is indeed defined as the negative logarithm (base 10) of hydrogen ion concentration.

5. **Maintenance of the body's acid-base balance is provided by buffer systems and physiological mechanisms of compensation.**
   - This statement is correct as well, as the body employs buffer systems (like bicarbonate, phosphate, and protein buffers) and physiological mechanisms (like respiratory and renal compensation) to maintain acid-base balance.

### Summary:
The incorrect statements are **2** and **3**.

What is a slowing down and complete stop of blood flow in capillaries, small arteries and veins, resulting in chronic hypoxia, which may lead to degeneration or even death of parenchymal cells

The condition you are describing is known as **ischemia**. 

### Explanation:
- **Ischemia** refers to an inadequate blood supply to an organ or part of the body, especially the heart muscles. This condition results in a slowing or complete cessation of blood flow, especially in the microvasculature, including capillaries, small arteries, and veins.
  
- Prolonged ischemia leads to **chronic hypoxia**, where tissues do not receive sufficient oxygen and nutrients needed for their metabolic processes. If ischemia persists, it may result in the degeneration of tissues (also referred to as **necrosis**) or **cell death** of parenchymal cells, which are the functional cells of the organ.

In summary, ischemia is characterized by reduced blood flow, leading to hypoxia and potentially causing significant tissue damage or loss.

Match the main factors contributing to thrombosis with their characteristics.

Impairments of blood coagulation

Answer 1 Question 96
Increased activity of coagulation and reduced anticoagulant activity systems
Endothelial injury

Answer 2 Question 96
Twists, turbulent blood flow (clots more often formed in the veins than in the arteries)
Slowing of blood flow

Answer 3 Question 96
Occur under the influence of physical, chemicals, biological factors and metabolic disorders

Here’s the correct matching of the main factors contributing to thrombosis with their characteristics:

1. **Impairments of blood coagulation**  
   **Answer 1:** Increased activity of coagulation and reduced anticoagulant activity systems

2. **Endothelial injury**  
   **Answer 3:** Occur under the influence of physical, chemicals, biological factors and metabolic disorders

3. **Slowing of blood flow**  
   **Answer 2:** Twists, turbulent blood flow (clots more often formed in the veins than in the arteries)

### Summary of Matching:
- **Impairments of blood coagulation** → **Increased activity of coagulation and reduced anticoagulant activity systems**
- **Endothelial injury** → **Occur under the influence of physical, chemicals, biological factors and metabolic disorders**
- **Slowing of blood flow** → **Twists, turbulent blood flow (clots more often formed in the veins than in the arteries)**

This matching reflects the key factors involved in the development of thrombosis.

Choose the correct parts of mixed thrombus.

Question 97Answer

1.
body


2.
neck


3.
head


4.
tail


5.
root

In the context of a mixed thrombus (a thrombus composed of different components such as red blood cells, platelets, and fibrin), the correct parts typically include:

1. **Body**  
   - This refers to the main mass or bulk of the thrombus.

2. **Head**  
   - The head of the thrombus is the area that is usually situated at the leading edge and can be where the thrombus is actively forming and where it might engage with blood flow.

3. **Tail**  
   - The tail of the thrombus extends backward into the direction of blood flow and can vary in length.

### Incorrect Options:
- **Neck** and **Root** are not standard anatomical parts commonly used to describe thrombi in clinical terminology.

### Therefore, the correct parts of a mixed thrombus are:
- **Body**
- **Head**
- **Tail** 

Thus, the answers selected should include **1 (body)**, **3 (head)**, and **4 (tail)**.

Choose the causes of passive hyperemia.

Question 98Answer

1.
After removal of coronary occlusion


2.
After removal the tourniquet


3.
Gastrointestinal activity


4.
Cardiac activity


5.
Mental activity

Passive hyperemia, also known as venous hyperemia, occurs when there is an accumulation of blood in the veins due to an obstruction or decreased outflow, leading to increased venous pressure and potential tissue edema. 

The correct causes of passive hyperemia from the provided options are:

1. **After removal of coronary occlusion**: When an occlusion is removed, blood flow returns to the affected area, leading to passive hyperemia.

2. **After removal of the tourniquet**: Upon release of a tourniquet, blood flow to the previously constricted area is restored, causing a rapid influx of blood, which can lead to passive hyperemia.

### The other options (which do not typically cause passive hyperemia):
3. **Gastrointestinal activity**: While this can result in increased blood flow to the gastrointestinal tract (an example of active hyperemia), it does not lead to passive hyperemia.

4. **Cardiac activity**: This refers to the heart's contraction and does not directly cause passive hyperemia; rather, it is essential for maintaining circulation.

5. **Mental activity**: Increased blood flow to the brain during mental activity represents active hyperemia related to increased metabolic demand, not passive hyperemia.

Therefore, the causes of passive hyperemia are **1 (After removal of coronary occlusion)** and **2 (After removal of the tourniquet)**.

is a programmed form of death of individual cells that occurs under the influence of extra- or intracellular factors, which is carried out by activating specialized intracellular processes regulated by certain genes.

The process you are describing is known as **apoptosis**.

### Explanation:
- **Apoptosis** is a form of programmed cell death that occurs in multicellular organisms. It is a highly regulated process that allows cells to die in a controlled manner, as opposed to necrosis, which is uncontrolled cell death typically resulting from injury or disease.
- Apoptosis can be triggered by various extracellular factors (such as cytokines, hormones, or cellular stress signals) as well as intracellular factors (like DNA damage or the activation of specific cellular pathways).
- This process involves a series of biochemical events leading to characteristic cellular changes, including cell shrinkage, chromatin condensation, and fragmentation of the nucleus. Ultimately, apoptotic cells are cleared away by phagocytes without causing an inflammatory response.
- The regulation of apoptosis is controlled by a range of genes, including those that produce pro-apoptotic and anti-apoptotic factors.

In summary, apoptosis is a crucial mechanism for maintaining cellular homeostasis, development, and eliminating damaged or unwanted cells.

Patient F.,67 years, suffers from chronic diffuse glomerulonephritis. He was admitted to hospital with severe renal insufficiency, olyguria. The blood test revealed:

рН of arterial blood = 7,30
раСО2 = 28 mm Hg
НСО3– = 13 mmol/L
ВЕ = -7 mmol/L

Determine the type of acid-base state disorder in the patient:

Question 100Answer

1.
non-respiratory (metabolic) mechanism


2.
decompensated acidosis


3.
respiratory mechanism


4.
non-respiratory (excretory) mechanism


5.
subcompensated acidosis

To analyze the acid-base status of Patient F based on the provided lab values:

- **pH** = 7.30 (Acidemia; normal range is 7.35-7.45)
- **pCO2** = 28 mm Hg (Low; normal range is approximately 35-45 mm Hg)
- **HCO3⁻** = 13 mmol/L (Low; normal range is approximately 22-26 mmol/L)
- **Base Excess (BE)** = -7 mmol/L (Significantly negative, indicating a substantial deficit of bicarbonate)

### Interpretation:

1. **Acidemia** (pH < 7.35) indicates acidosis.
2. The **low HCO3⁻** level suggests a primary metabolic acidosis. The kidneys are unable to excrete acid or regenerate bicarbonate due to chronic renal failure.
3. The **low pCO2** means that the respiratory system is trying to compensate for metabolic acidosis by hyperventilating to blow off carbon dioxide.

### Conclusion:

Given that:
- The pH is low, indicating acidosis.
- The HCO3⁻ is low, suggesting a metabolic component to this acidosis.
- The low pCO2 reflects an attempt at respiratory compensation but is not sufficient to normalize the pH.

### Options Assessment:

1. **Non-respiratory (metabolic) mechanism**: This is partly correct, as the metabolic process is indeed primarily responsible for the acidosis.
   
2. **Decompensated acidosis**: This indicates that the body is unable to compensate adequately for the acid-base disturbance, which is likely the situation here due to renal insufficiency and the resultant pH.

3. **Respiratory mechanism**: This does not apply here as the primary issue is metabolic, not respiratory.

4. **Non-respiratory (excretory) mechanism**: This could refer to the renal failure aspect leading to the inability to excrete acids; however, it does not overtly indicate the type of acidosis.

5. **Subcompensated acidosis**: Since the pH is significantly low (7.30) with inadequate compensation reflected in HCO3⁻ and pCO2, this would not be an adequate description.

### Best Answer:

Considering the provided information and the implications of the blood gas results, the best answer is:

**2. Decompensated acidosis**. 

This diagnosis captures the state of significant acidosis with renal failure and inadequate compensation.

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