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Gen Med (Renal) > Physiology 6 - Acid Base Balance > Flashcards

Physiology 6 - Acid Base Balance Flashcards

1
Q

What is the normal pH range of blood?

A

7.35 - 7.45

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2
Q

Why is venous blood more acidic than arterial blood?

A

It contains more CO2

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3
Q

What effect does acidosis have on the nervous system?

A

CNS depression

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4
Q

What effect does alkalosis have on the nervous system?

A

Hyperactivity of the PNS, and eventually CNS

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5
Q

What effect does acidosis have on potassium concentrations?

A

Hyperkalaemia

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6
Q

What is formed in the middle step of the buffer system for acid base balance in the body?

A

Carbonic acid

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7
Q

The formation of carbonic acid from carbon dioxide and water is catalysed by what enzyme?

A

Carbonic anhydrase

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8
Q

The concentration of plasma bicarbonate is controlled by what body system?

A

Renal

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9
Q

The partial pressure of carbon dioxide is controlled by what body system?

A

Respiratory

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10
Q

Reabsorption of bicarbonate in the tubules of the nephron is driven by what?

A

Secretion of hydrogen ions

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11
Q

When bicarbonate concentrations in tubular fluid are low due to reabsorption, what do secreted hydrogen ions combine with instead?

A

Phosphate

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12
Q

In individuals with severe acidosis, excess hydrogen ions can combine with what to be excreted in the urine?

A

Ammonia

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13
Q

Death occurs if the pH of blood drops below what value?

A

6.8

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14
Q

Death occurs if the pH of blood rises above what value?

A

8

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15
Q

What is the average plasma HCO3- concentration?

A

25mmol/l

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16
Q

What is the average partial pressure of arterial CO2?

A

40mmHg

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17
Q

What is meant by compensation of an acid base balance?

A

Restoration of the pH, irrespective of what happens to bicarbonate and carbon dioxide

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18
Q

What is meant by correction of an acid base balance?

A

Restoration of the pH, bicarbonate and carbon dioxide

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19
Q

What acid base balance disruption occurs when carbon is retained by the body?

A

Respiratory acidosis

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20
Q

Clinically, what is the cause of respiratory acidosis?

A

Type 2 respiratory failure

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21
Q

What happens to pH and partial pressure of carbon dioxide in uncompensated respiratory acidosis?

A

pH is low, partial pressure of carbon dioxide is high

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22
Q

How is respiratory acidosis compensated for?

A

Reabsorption of bicarbonate and formation of ‘new’ bicarbonate

23
Q

What acid base balance disruption occurs when there is excess removal of carbon dioxide by the body?

A

Respiratory alkalosis

24
Q

Clinically, what is the cause of respiratory alkalosis?

A

Hyperventilation

25
Q

What happens to pH and partial pressure of carbon dioxide in uncompensated respiratory alkalosis?

A

pH is high, partial pressure of carbon dioxide is low

26
Q

How is respiratory alkalosis compensated for?

A

Excretion of bicarbonate in urine

27
Q

What is the most common acid base disturbance?

A

Metabolic acidosis

28
Q

What acid base balance disruption occurs when there is excess hydrogen ions in the blood, from a source which is not carbon dioxide?

A

Metabolic acidosis

29
Q

What happens to pH and bicarbonate concentration in uncompensated metabolic acidosis?

A

pH is low, bicarbonate concentration is low

30
Q

How is metabolic acidosis compensated for?

A

Increased ventilation

31
Q

What acid base balance disruption occurs when there is excessive loss of hydrogen ions from the body, from a source which is not carbon dioxide?

A

Metabolic alkalosis

32
Q

What happens to pH and bicarbonate concentration in uncompensated metabolic alkalosis?

A

pH is high, bicarbonate concentration is high

33
Q

How is metabolic alkalosis compensated for?

A

Decreased ventilation

34
Q

Which acid base disturbance often occurs in pregnancy?

A

Respiratory alkalosis

35
Q

Which acid base disturbance can be caused by burns?

A

Metabolic alkalosis

36
Q

Which acid base disturbance can be caused by diarrhoea?

A

Metabolic acidosis

37
Q

Which acid base disturbance can be caused by vomiting?

A

Metabolic alkalosis

38
Q

Which acid base disturbance can be caused by diuretic use?

A

Metabolic alkalosis

39
Q

Which acid base disturbance can be caused by a PE?

A

Respiratory alkalosis

40
Q

In which acid-base disorder is the anion gap of significance?

A

Metabolic acidosis

41
Q

What does the anion gap estimate?

A

Unmeasured plasma ions (e.g. phosphate, ketones, lactate)

42
Q

How is the anion gap calculated?

A

(Sodium + potassium) - (chloride + bicarbonate)

43
Q

What is the normal anion gap?

A

10 - 18mmol/l

44
Q

Metabolic acidosis with a normal anion gap can be due to what two things?

A

Loss of bicarbonate or ingestion of H+ ions

45
Q

Metabolic acidosis with a raised anion gap is due to what?

A

Increased production or reduced excretion of organic acids

46
Q

What is the anion gap in metabolic acidosis caused by renal tubular acidosis?

A

Normal

47
Q

What is the anion gap in metabolic acidosis caused by diarrhoea?

A

Normal

48
Q

What is the anion gap in metabolic acidosis caused by Addison’s disease?

A

Normal

49
Q

What is the anion gap in metabolic acidosis caused by shock, infection or tissue ischaemia?

A

Raised (raised lactate)

50
Q

What is the anion gap in metabolic acidosis caused by renal failure?

A

Raised (raised urate)

51
Q

What is the anion gap in metabolic acidosis caused by DKA?

A

Raised (raised ketones)

52
Q

Hypokalaemia is associated with which acid-base disorder?

A

Metabolic alkalosis

53
Q

Hyperkalaemia is associated with which acid-base disorder?

A

Metabolic acidosis

54
Q

What will the PaO2 usually be in patients with respiratory acidosis?

A

Low

Gen Med (Renal) (18 decks)

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