Acid base Flashcards
What is the difference between alklaemia/acidimia and alkylosis acidosis
aemia refres to the pH of the blood osis is the process that that occurs that leads to that change
what is the most dagerous change in alkalaemia and why
hypocalcaemia, hydrogen ions arereleased from the proteins and calcium binds
7.45 => paraesthesia and tetany
pH 7.55=> 45% mortality
pH 7.65=> 80% mortality
what is the link between K and H
increase in one leads to decrease in the other i.e. in nephrons and cells
Why is metabolic acidosis easierto compensate than m alkylosis
acidosis compensated by hyperventilation
limited ability too hypobentilate
Where is HCO3- reabsorbed and what is the enzyme involved
PCT 80-90% and TAL 15%
carbonic anhydrase
What are teh two pathways of HCO3- synthesis in the kidney
glutamate breakdown (HCO3- and NH4+) from CO2 in intercalated cells (increased K as a result)
how is H+ managed in the filtrate
actively pumped out as well as exchanged with K
reacts with hydrogen phosphate HPO4(2-)
neutralised by NH4+
how does vomiting lead to metabolic alkylosis
bicarbonate production as a biproduct of H+. Dehydration prevents excretion in kidney
how can you calculate anion gap.
(Na + K) - (HCO3- +Cl-)
(+ve - -ve)
what does increase oin value of anion gap suggests (normal =10-15mmol)
metabolic acidosis
how can you distinigish between compensated respiratory alkalosis and compensated respiratory acidosis? how can you distinguish between the two
if pCO2 follows HCO3- then metabolic acidosis (with increased anion gap)
if HCO3- follows pCO2 its respiratory alkalosis
how is contince achieved in the bladder (sympathetic)
sympathetic innervation from L-centre through hypogastric nerve(T10-L2) stimulates:
beta3=> detruser relaxation
alpha1=> internal urethral sphincter contraction
how is contince achieved in the bladder (somatic)
signal from Onuf’s nucles via pudendal nerve(S2-4) => extrenal urethral sphincter contraction
what is stress-relaxation phenomenon
relaxation of thedartos massuls with fillingofthe bladder (to a limit) to avoid raise in pressure
What are the changhes during micturatoin
sympathetic tone reduced
parasympathetic tone increased=>contraction of dartos stimulated by M3 (fro pelvic nerve)
relaxation of EUS
