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Physiology for Pharmacy > Renal 5: Acid-Base Balance > Flashcards

Renal 5: Acid-Base Balance Flashcards

1
Q

body fluid pH is tightly regulated by ___

A

buffering

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2
Q

___ is the most important physiological pH buffer

A

bicarbonate

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3
Q

bicarbonate buffering is regulated by the ___ and ___

A

kidneys and lungs

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4
Q

what happens to practically all of the HCO3 filtered by the kidneys?

A

reabsorbed by different mechanisms

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5
Q

secreted H is excreted as __ or ___

A

titratable acid or as NH4+

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6
Q

acid-base disorders have several causes and result in renal and respiratory ___ mechanisms

A

compensatory

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7
Q

the kidneys respond to changes in blood pH by ___ and ___

A

inceasing or decreasing acid secretion and HCo3 reabsorption

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8
Q

what is the pH range of urine?

A

4.5-8

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9
Q

what are the 2 acid inputs to plasma?

A

diet (fatty and amino acids) and metabolism (CO2, H2O, Lactic acids, ketoacids)

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10
Q

what are the 2 acid outputs from the plasma?

A

expiration of volatile acids from the lungs & excretion of fixed acids by the kidneys

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11
Q

the phosphate buffers are important in __ and ))

A

intracellular fluid and urine

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12
Q

what enzyme changes co2 and water into carbonic acid?

A

carbonic anhydrase

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13
Q

carbonic acid dissociates into __ and __

A

bicarbonate and H+

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14
Q

buffers prevent ___ in pH when H+ levels change

A

large changes

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15
Q

at low pH, what is the dominant form?

A

weak acid (protonated)

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16
Q

at high pH what is the dominant form?

A

weak base, (deprotonated)

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17
Q

the ___ equation relates the buffer levels to overall pH

A

henderson hasslebach

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18
Q

at low pH is CO2 or Bicarb dominant?

A

CO2

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19
Q

at high pH is CO2 or Bicarb dominant?

A

Bicarb

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20
Q

what happens to CO2 and hCO3- when acid is added? 1

A

HCO3 is reabs and CO2 expired

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21
Q

what happens to CO2 and HCO3- when base is added?

A

HCo3 excreted and Co2 decreased reabsorption

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22
Q

at pH 7.4, what is the dominant form of the bicarbonate buffer?

A

HCO3-

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23
Q

most of the HCO3 is reabsorbed in ____ of the nephron

A

proximal tubule

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24
Q

secretion of H is done by ___ transporters in the __ membrane of the proximal tubule

A

Na/H antiporter; apical

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25
Q

the secretion of H is driven by the formation of ___ in the cell in the proximal tubule

A

H2CO3

26
Q

bicarbonate is reabsorbed across the __ membrane by ___ in the proximal tube

A

basolateral; facillitated diffsuin transporte

27
Q

the H ions that secreted are used to reclaim HCO3 to make ___ and __

A

co2 and water

28
Q

the conversion of H2CO3 to h20 and Co2 is performed by ___ which is tethered to the apical membrane

A

carbonic anhydrase

29
Q

the Co2 made when H is secreted is used to make more __ within the cell

A

carbonic acid (that will make bicarb and more H for more cycling)

30
Q

net secretion of H; charge of tubular fluid pH__ in the proximal tube

A

none; none

31
Q

how is H secreted across the apical membrane in the collecting duct?

A

proton pump (H ATPase)

32
Q

how is bicarb reabsorbed across the baso membrane in the collecting duct?

A

HCO3 Cl transporter

33
Q

in the collecting duct, the secretion of H is coupled to __

A

formation and reabsorption of HCo3

34
Q

Alpha intercalted cells act reverse to__

A

acidosis

35
Q

beta intercalated cells act to reverse __

A

alkalosis

36
Q

___ is secreted and __ is reabsorbed by the alpha intercalated cells

A

H; HCO3

37
Q

___ is secreted and ___ is reabsorbed by the beta intercalated cells

A

hco3; H

38
Q

what transporter is used to secrete HCO3 from the beta intercalated cells?

A

pendrin

39
Q

t/f pendrin is special to the apical membrane

A

t

40
Q

is the alpha or beta intercalated cell dominant under most cases?

A

alpha

41
Q

in diabetic patients, the the total production of H and excretion as either titratable acids or NH4 is much ___ compared to normal

A

higher

42
Q

how does the total production of H and excretion as Nh4 and titratable acids in patients with renal failure compare to that of a normal patient?

A

total H is the same; but excretion in these forms is lower

43
Q

metabolic acidosis is caused by __

A

decresed HCO3

44
Q

metabolic alkalosis is caused by __

A

increased HCO3

45
Q

respiratory acidosis is caused by

A

increased PCO2

46
Q

respiratory alkalosis is caused by

A

decreased PCO2

47
Q

give 2 possible conditions leading to metabolic acidosis

A

diarrhea (loss of hCO3) and ketoacidosis (raised H)

48
Q

give 2 possible conditions leading to metabolic alkalosis

A

vomiting (loss of H) and eating too much HCO3

49
Q

give an example of a condition that may cause respiratory acidosis

A

COPD / hypoventillation

50
Q

give an example of a condition that may cause respiratory alkalosis

A

hyperventillation

51
Q

what is the respiratory compensation for metaboilc alkalosis?

A

hypoventilation

52
Q

what is the respiratory compensation for metabolic acidosis?

A

hyperventilation

53
Q

in response to acidosis, phosphate reabsorption is ___ by the proximal tubule

A

decreased (to maintain buffering in urine)

54
Q

in response to alkalosis, phosphate reabsorption id ___ by the proximal tubule

A

icreased

55
Q

pH above 7.4 is

A

alkalosis

56
Q

pH below 7.4 is

A

acidosis

57
Q

{HCO3} above 24 mEq/L is

A

metabolic alkalosis

58
Q

[HCO3] below 24 mEq/L is

A

metabolic acidosis

59
Q

PCO2 below 40 mmhg is

A

respiratory alkalosis

60
Q

PCO2 above 40 mmHG is __-

A

respiratory acidosis

Physiology for Pharmacy (39 decks)

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