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MET 2 > Acid base > Flashcards

Acid base Flashcards

1
Q

What does ph stand for

A

Potential of hydrogen

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2
Q

What is the ph of gastric juice

A

2

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3
Q

What is the ph of inside of small intestine

A

8

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4
Q

State some ways in which acid can be produced in the body

A
  • Breakdown of food esp protein
    • CO2 metabolised and forms carbonic acid with water
  • Acids resulting from other metabolic activity such as lactic acid in exercise
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5
Q

Name the 3 ways that the body can regulate acid base

A
  • Chemical buffers in blood and interstitial fluid
  • Respiratory centre in the brain stem
  • Renal mechanism
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6
Q

Define buffer

A

Solution that can resist pH change upon the addition of an acid or a base

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7
Q

What are the main buffer systems in the body

A
  • Bicarbonate
  • Proteins
  • Phosphates
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8
Q

What proteins are most commonly used as a buffer system

A

Haemoglobin in blood

Albumin in plasma

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9
Q

Can chemical buffers eliminate acids or bases from the body

A

No

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10
Q

Does acidemia lead to hypo/ hyper kalaemia

A

Hyper

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11
Q

Why does acidemia lead to hyperkalaemia

A

Cells take in more hydrogen so potassium is displaced

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12
Q

Why do alkalosis lead to hypokalaemia

A

Because hydrogen goes out of the cell so potassium mvoes in

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13
Q

Does anion gap measure levels in the blood or the plasma

A

Plasma

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14
Q

What are the cations used in anion gap

A

Unmeasured cations
K+
Na+

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15
Q

What are the anions used in the anion gap

A

Unmeasured anions
HCO3-
Cl-

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16
Q

What is meant by the magic 4

A 
way to remember levels of electrolytes in plasma
K+=4
Na+=140
HCO30=24
Cl-= 104
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17
Q

Name some of the unmeasured cations

A

Calcium
Magnesium
Proteins

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18
Q

Name some of the unmeasured anions

A

Phosphates
Sulfates
Proteins

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19
Q

What is a normal anion gap

A

8-12mEg/L

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20
Q

How do you calculate anion gap

A

Na+-(Cl-+HCO3-)

21
Q

Why does a loss of bicarbonate causing acidosis not lead to a change in anion gap

A
  • Chloride compensates for loss of bicarbonate

- There is an exchange of chloride and bicarbonate

22
Q

What is it called when there is a surge of chloride leading to acidosis

A

Hyperchloremic acidosis

23
Q

What are the causes of normal gap acidosis?

A

‘gut stuff’ leading to bicarb loss

  • Severe diarrhoea
  • Laxative abuse
  • Villous adenoma
  • Others
24
Q

Name some causes of normal gap acidosis

A
  • Bicarbonate loss

- Reduced kidney H+ excretion

25
Q

Why does reduced kidney H+ secretion lead to normal gap acidosis

A

If kidneys are not able to excrete acids efficiently, more HCO3- is needed to buffer them leading to drop in bicarbonate (lost into carbonic acid)

26
Q

Causes of reduced kidney H+ excreted

A

Renal failure

27
Q

How far up can the elevated anion gap go

A

24mEg/L

28
Q

What are the causes of elevated gap acidosis

A

Too much acid or not enough bicarbonate is being produced:

  • Ketoacidosis
  • Lactic acidosis
  • Also severe renal failure
29
Q

Which unmeasured anion contributes to the majority of the value of anion gap

A

Albumin

30
Q

What causes low gap acidosis

A

Albumin dropped leading to surge in HCO3- and Cl-

  • Haemorrhage
  • Nephrotic syndrome
  • Intestinal obstruction
  • Liver cirrhosis
31
Q

What kind of acids do the lungs deal with

A

CO2

32
Q

What organ can prevent metabolic acidosis

A

Kidney

33
Q

Which 2 tasks must the kidney complete to control acid base balance

A
  • Reabsorption of all filtered bicarbonate

- Excrete the daily acid load

34
Q

Where is 70-90% of the bicarbonate reabsorbed

A

Proximal convuluted tubule

35
Q

Where is 10-30% of the bicarbonate reabsorbed

A

Throughout rest of the nephron (after PCT)

36
Q

Which enzyme breaks HCO3 into CO2 and OH

A

Carbonic anhydrase

37
Q

Where in the kidney does active excretion of H+ happen

A

Various parts of the distal kidneys

38
Q

What do alpha intercalated cells secrete and reabsorb

A

Secretes acid

Reabsorbs HCO3-

39
Q

What pumps does alpha intercated cell use to excrete acid

A

H+ ATPase pump

H+/K+ exchanger

40
Q

What do beta intercalated cells excrete/ absorb

A

Secretes HC03-

Reabsorbs acid

41
Q

How do renal tubule cells act during acidosis

A
  • Need to get rid of H+ into the lumen using sodium transporter
  • Bicarbonate moves into the cell
42
Q

Which 2 systems are used to allow excretion of acid

A

HPO42- buffer and ammonium

43
Q

Which pathways is used by kidneys to produce bicarbonate

A

Glutimate pathway

44
Q

How do renal cells act during alkalosis

A

Tubular cells secrete bicarbonate ions and reclaim hydronium to acidify the body
This uses separate ATPase
K+ traded for H+

45
Q

What are the stimuli for HCO3- reabsorption in PCT

A

Low ph
Low K+
Angiotensin II

46
Q

What does drop in ph or increase in aldosterone do to the collecting duct

A
  • Sodium reabsorption

- Displaced by H+ and K+

47
Q

What does the Henderson-Hasselbach equation find

A
  • pH of buffer solution

- ratio of conjugate base: acid

48
Q

pH=

A

PKa + log (conjugate base)/ (acid)

49
Q

What does pKa=

A

-log( equilibrium constant)

MET 2 (32 decks)

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