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GERR > Physiology - Renal regulation of H+ > Flashcards

Physiology - Renal regulation of H+ Flashcards

1
Q

what is the normal pH of the ECF?

a.7.35 - 7.45
b.2.35-2.45
c.5.35-5.45

A

a.7.35 - 7.45

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2
Q

what is the pH of the intracellular fluid

a.7.0
b.7.1
c.7.2
d.7.3

A

c.7.2
more acidic than ECF due to intracellular acid production

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3
Q

the protein buffer system and the bicarbonate buffer system are examples of which type of buffer

a.chemical
b.physiological

A

a.chemical

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4
Q

in the bicarbonate buffer system what is the role of carbonic anhydrase

a.converts co2 and h2o to carbonic acid
b.converts carbonic acid to bicarbonate and h+

A

a.converts co2 and h2o to carbonic acid

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5
Q

the renal and respiratory system are examples of which type of buffer
a.chemical
b.physiological

A

b.physiological

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6
Q

type of buffer have a better buffering capacity

a.physiological
b.chemical

A

a.physiological

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7
Q

which system stabilises pH by controlling the output of acids and bases

a.respiratory
b.renal
c.bicarbonate

A

b.renal

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8
Q

which system stabilises pH by controlling the output of volatile acids including co2

a.respiratory
b.renal
c.bicarbonate

A

a.respiratory

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9
Q

which physiological buffer has a better buffering capacity

a.renal
b.respiratory
c.bicarbonate
d.protein

A

a.renal

but takes several hours to days
resp effective within minutes

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10
Q

in normal control of pH there is a small excess of what substance in the body leading it to be filtered at the glomerulus

a.H+
b.H2CO3
HCO3-

A

a.H+

filtered along with HCO3-

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11
Q

what happens to H+ in the filtrate

A

recombines with HCO3- to make H2CO3

H2CO3 dissociates into H2O and CO2

both diffuse into the tubular cell

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12
Q

what are H2O and CO2 converted to by carbonic anhydrase inside the tubular cell

a.H+ and HCO3-
b.H2CO3

A

b.H2CO3

then dissociates into HCO3- and H+

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13
Q

which substance diffuses from the tubule cell into the blood when the renal system is acting as a buffer

a.H+
b.HCO3-
c.H2CO3
d.H2O

A

b.HCO3-

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14
Q

which substance diffuses into the blood from the tubule cells when the renal system acts as a pH buffer

a.H+
b.HCO3-
c.H2CO3
d.H2O

A

a.H+

combines with HCO3- and cycle starts again

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15
Q

what is the net effect of when the renal system acts as a physiological buffer

A.H+ secreted, HCO3- reabsorbed
b. H+ excreted, HCO3- reabsorbed
c.HCO3- secreted, H+ reabsorbed

A

A.H+ secreted, HCO3- reabsorbed

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16
Q

urine is

a.acidic
b.alkali

A

a.acidic

H+ secretion> reabsorption

17
Q

During acidosis renal correction

A

all available HCO3- combines with H+
extra CO2 in filtrate reabsorbed

in the tubule cells extra H2CO3 made so more H+ and HCO3- made

more HCO3- into blood to make it less acidic

H+ secreted into filtrate

no more HCO3- to combine with so excreted in urine and urinary pH lower

ECF pH returned to normal

18
Q

what happens to urinary pH if acidosis is being corrected via the renal buffering system

a.increase
b.decrease

A

b.decrease

more CO2 combining with more H2O outside tubule cells
more into tubule cells to be converted to h2co3 and then H+ and HCO3-
more H+ secreted back into filtrate but no more HCO3- to combine with
so excess H+ is excreted in the urine
and ECF H+ returns to normal

19
Q

for H+ secretion what needs to be maintained

a.H+ conc gradient (lower in filtrate than blood)

a.H+ gradient (lower in blood than filtrate)

A

a.H+ conc gradient (lower in filtrate than blood)

20
Q

a pH of below what will stop H+ secretion and therefore limit the resorption of HCO3-

a.4.5
b.5.5
c.6.5

A

a.4.5
(high amount of H+ in filtrate so no gradient between this and the blood)

21
Q

when H+ is in excess in the filtrate and the gradient no longer is enogh for secretion H+ is combined with which substance in order to excrete it?

a.HCO3-
b. NH3
c.NH4+

A

b. NH3

from breakdown of amino acids
secreted by renal tubular cells
combined with H+ to form NH4+
Excreted in the urine

22
Q

the binding of which ion to plasma proteins is affected by a drop in pH

a.sodium
b.calcium
c.potassium
d.bicarbonate

A

b.calcium

23
Q

what happens to free calcium levels when H+ levels increase (uncompensated acidosis)

a.increase
b.decrease

A

b.calcium

H+ dispalces Ca2+ on albumin
Ca2+ is then free and blocks sodium channels reducing their opening
reduced AP firing in myocytes and nerves

bradycardia and asystole
stupor and coma

24
Q

what is the effect of the increased in free calcium in uncompensated acidosis binding to nerves and myocytes

a.more excitable
b.less excitable

A

b.less excitable

blocks sodium channels and reduces their opening

25
Q

which channels are blocked by free calcium in uncompensated acidosis

a.sodium
b.potassium
c.calcium

A

a.sodium

26
Q

what type of acidosis could be caused by ventilatory failure or COPD

a.respiratory
b.metabolic

A

a.respiratory

27
Q

renal injury, aspirin overdose, diarrhoea and alcoholism are possible causes of which type of acidosis

a.respiratory
b.metabolic

A

b.metabolic

28
Q

renal correction of alkalosis process

A

decreased H+ in filtrate means less H2CO3 formed in filtrate

less co2 and h2o formed in filtrate

less H2CO3 formed by carbonic anhydrase in the tubular cells

less HCO3- made and so less reabsorbed

less H+ made so less secreted (whil H+ made continuosly by body so increase in plasma H+)

surplus HCO3 excreted

29
Q

what happens to amount of free calcium in uncompensated alkalosis

a.increase
b.decrease

A

b.decrease

less H+ bound to plasma proteins so more Ca2+ binds to plasma proteins

less free Ca2+

less blockage of sodium channels so increased opening and increased AP firing

increased nerve and myocyte activity

confusion, muscle spasms , death

30
Q

what can hyperventilation cause

a.respiratory acidosis
b.respiratory alkalosis
c.metabolic alkalosis
d.metabolic acidosis

A

b.respiratory alkalosis

31
Q

what can antacid overdose, hyperaldosteronismand vomiting cause

a.respiratory acidosis
b.respiratory alkalosis
c.metabolic alkalosis
d.metabolic acidosis

A

c.metabolic alkalosis

32
Q

patient has arterial blood sample with ph >7.4, PCO2 <40 mmHg , and HCO3- <24

what type of alkilosis is this

a.respiratory
b.metabolic

A

a.respiratory

33
Q

patient has arterial blood sample with ph >7.4, PCO2 <40 mmHg , and HCO3- <24

what is the likely cause

a.hyperventilation
b.COPD
c.antacid overdose
d.renal disease

A

a.hyperventilation

acidosis or alkalosis? - alkilosis

co2 low = alot being blown off at lungs so hyperventilation

HCO3 low
as less HCO3- is being reabsorbed to compensate for the alkilosis going on elsewhere ie resp

34
Q

patient has arterial blood sample with ph >7.4, PCO2 >40mmHg , and HCO3- >24mmHg

what is the likely cause

a.hyperventilation
b.COPD
c.antacid overdose
d.renal disease

A

c.antacid overdose

high pH so alkalosis

metabolic or resp?

hco3- - high so metabolic
pco2 high so must be resp compensation for metabolic alkalosis

35
Q

patient has arterial blood sample with ph <7.4, PCO2 >40mmHg , and HCO3- >24mmHg

what is the likely cause

a.hyperventilation
b.COPD
c.antacid overdose
d.renal disease

A

ph <7.4 = acidosis

metabolic or resp?

high pco2 - not much blown off in lungs

high hco3- - renal compensation for this

so resp
b.COPD

36
Q

patient has arterial blood sample with ph <7.4, PCO2 <40mmHg , and HCO3- <24mmHg

what is the likely cause

a.hyperventilation
b.COPD
c.antacid overdose
d.renal disease

A

acidosis as pH<7.4

metabolic or resp

HCO3- low so not much alkali hco3- reabsorbed and acidosis is metabolic

pco2 - low so alot of CO2 being blown off so a resp compensation and acidosis must be elsewhere

GERR (53 decks)

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