Acid and Base

Question 1

what are the main 2 organs which are involved in acid base balance

Answer 1

kidney and lungs.

Question 2

what 3 components contribute to the daily acid production

Answer 2

total carbon dioxide
unmetabolised acids
plasma [H +]

Question 3

how much carbon dioxide is produced in a day

Answer 3

25mol/day

Question 4

how much unmetabolised acids are produced a day

Answer 4

50mmol/day

Question 5

How much plasma [H+] is produced a day.

Answer 5

40 nmol/L

Question 6

what effect will the wrong pH have upon proteins

Answer 6

It will cause them to denature.

Question 7

what are the buffering solutions of maintaing the blood pH

Answer 7

haemoglobin
bicarbonate
phosphate
proteins
ammonia
organic acids

Question 8

define pH

Answer 8

concentration of hydrogen ions

Question 9

what is the reference range fore [H+]

Answer 9

35-45 nmol/L

Question 10

what is the reference range of pH

Answer 10

7.35-7.45

Question 11

what is the name of the equation which is used to show the glance between H+ production and HCO3- reduction.

Answer 11

Henderson- Hasselbalch equation

Question 12

what do H+ and HCO3- produce according to the henderson hasselbach equation.

Answer 12

carbon dioxide and water

Question 13

when does the oxygen dissociation have a right shift

Answer 13

RIGHT

Right shift Increased 2,3, diPG, acidosis H+, Temperature (cold)

Question 14

how is acid base balanced at the renal tubule

Answer 14

Na+ and HCO3- enter the renal tubule
Na+ is pumped out and H + is pumped in.
H+ combines with HCO3- forming H2CO3
this forms CO2 and H20
carbon dioxide is excreted
CO2 once again forms H2CO3 whig then splits into H+ and HCO3-

Question 15

how is acid base balanced at the renal tubule (ammonia)

Answer 15

Na+ and HPO4- enter the renal tubule
Na+ is pumped out and H + is pumped in.
H+ combines with NH3 which is made from glutamine and then pumped in.

Question 16

what happens at the dotal renal tubule which may affect the acid base balacne

Answer 16

Distal tubule k+/h+
Complete for excretion.
Increase hydrogen excretion acidosis
Increased potassium excretion alkalosis.

Question 17

How is the acid base balanced in the GI system,

Answer 17

Hydrogen in stomach helps to breakdown food.

HCO3- in the pancreas helps to neutralise the acid of the pancreas to prevent the denaturing of pancreatic enzymes.

Question 18

what metabolism occurs in the liver which is related to acid base balance

Answer 18

dominant site of lactate metabolism

only site of urea synthesis- this maintains the hydrogen ion concentration.

Question 19

what 2 components are all proteins and amino acids broken down into

Answer 19

carbon skeleton

amino acids

Question 20

what is the main function of the liver in acids base balance

Answer 20

maintain the hydrogen ion concentration

Question 21

If severe liver failure happens why happened to the molecules involved in acid base balance

Answer 21

NH4+ does not form glutamine.

NH4+ an HCO3- can therefore never make H+

Question 22

what is the consequence of liver failure

Answer 22

alkalosis.

H+ not formed

Question 23

define co-oximeter

Answer 23

machine which shows and measure abnormal haemoglobin

Question 24

what measurement does a gas analyse not give

Answer 24

Bicarbonate

gives hydrogen, oxygen pressure and co2 pressure

Question 25

what are the compensatory mechanisms for excess H+

Answer 25

respiratratory renal bicarbonate regeneration Hepatic shift between urea synthesis and ammonia excretion

Question 26

what causes metabolic acidosis

Answer 26

increased H+ formation acid ingestion reduced renal H+ excretion loss of bicarbonate

Question 27

what causes metabolic alkalosis.

Answer 27

generation of HCO3- by gastric mucosa renal generation of HCO3- in hypokalaemia. administration of bicarbonate.

Question 28

What are the consequences of metabolic alkalosis

Answer 28

K+ in cells and urine. PO4 in cells. Respiratory suppression- caused by vommitting and diahorrhea, ectopic ACTH in cushing's syndrome.

Question 29

what causes respiratory acidosis

Answer 29

``` CO2 retention due to 1: inadequate ventilation 2: parenchymal lung disease 3: inadequate perfusion • Breathlessness ```

Question 30

what causes respiratory alkalosis

Answer 30

Increased CO2 excretion due to excessive ventilation producing alkalosis • Acute asthma distress. • CO2 excretion > CO2 production

Question 31

what causes metabolic acidosis

Answer 31

Diabetes is not in control which results in renal function disturbance- quite common. MI -CO binds haemoglobin and doesn’t let go of it o the body has reduced oxygen carrying capacity. alcoholiC- NAD+ depletion (thiamine), thiamine deficiency (PDH co-factor), enhanced glycolysis for ATP formation, keto-acids (b-HBD) 20 to counter-regulatory hormones, profuse vomiting

Question 32

what factors increase H+ formation

Answer 32

ketoacidosis, diabetic or alcoholic lactic acidosis- symptom not diagnosis poisoning inherited organic acidosis

Question 33

what causes lactic acidosis

Answer 33

shock | metabolic and toxic causes.

Question 34

In alkalosis

Answer 34

increased glycolysis reduced O2 delivery due to shift in O2 dissociation curve lactate induced vasoconstriction impaired mitochondrial respiration

Question 35

how does renal failure result in increased acidosis

Answer 35

* Increased bicarbonate loss * Reduced NH4+ excretion * NH4+ to liver for urea + H+ synthesis * only fraction of NH4+ derived from glutamine

Question 36

in respiratory acidosis are the hydrogen, carbon dioxide and oxygen levels increased or decreased

Answer 36

hydrogen is high carbon dioxide is high oxygen is low

Question 37

In respiratory alkalosis carbon dioxide and oxygen levels increased or decreased

Answer 37

hydrogen is low carbon dioxide is low oxygen is high

Question 38

In metabolic acidosis carbon dioxide and oxygen levels increased or decreased

Answer 38

hydrogen is high carbon dioxide is low oxygen is high

Question 39

in metabolic alkalosis carbon dioxide and oxygen levels increased or decreased

Answer 39

hydrogen is low carbon dioxide is high oxygen is low.

Question 40

what mechanisms help to control hydrogen level

Answer 40

glutamine to ammonia in renal tubule renal tubules and production of excess bicarbonate excretion of hydrogen bicarbonate in the blood.

Question 41

what does liver failure cause

Answer 41

metabolic alkalosis

Question 42

what does renal failure cause

Answer 42

metabolic acidosis.

Question 43

what causes diabetic acidosis

Answer 43

hyperglycaemia osmotic diuresis ------- to pre-renal uraemia hyperketonaemia increased FFA

Question 44

What causes lactic acidosis

Answer 44

CO binds haemoglobin and doesn’t let go of it o the body has reduced oxygen carrying capacity.

Question 45

what causes alcoholic acidosis

Answer 45

``` NAD+ depletion (thiamine) Thiamine deficiency (PDH co-factor) enhanced glycolysis for ATP formation keto-acids (b-HBD) 2 to counter-regulatory hormones profuse vomiting ```