Acid base

Question 1

What is the difference between alklaemia/acidimia and alkylosis acidosis

Answer 1

aemia refres to the pH of the blood osis is the process that that occurs that leads to that change

Question 2

what is the most dagerous change in alkalaemia and why

Answer 2

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

Question 3

what is the link between K and H

Answer 3

increase in one leads to decrease in the other i.e. in nephrons and cells

Question 4

Why is metabolic acidosis easierto compensate than m alkylosis

Answer 4

acidosis compensated by hyperventilation

limited ability too hypobentilate

Question 5

Where is HCO3- reabsorbed and what is the enzyme involved

Answer 5

PCT 80-90% and TAL 15%

carbonic anhydrase

Question 6

What are teh two pathways of HCO3- synthesis in the kidney

Answer 6

glutamate breakdown (HCO3- and NH4+)
from CO2 in intercalated cells (increased K as a result)

Question 7

how is H+ managed in the filtrate

Answer 7

actively pumped out as well as exchanged with K
reacts with hydrogen phosphate HPO4(2-)
neutralised by NH4+

Question 8

how does vomiting lead to metabolic alkylosis

Answer 8

bicarbonate production as a biproduct of H+. Dehydration prevents excretion in kidney

Question 9

how can you calculate anion gap.

Answer 9

(Na + K) - (HCO3- +Cl-)

(+ve - -ve)

Question 10

what does increase oin value of anion gap suggests (normal =10-15mmol)

Answer 10

metabolic acidosis

Question 11

how can you distinigish between compensated respiratory alkalosis and compensated respiratory acidosis? how can you distinguish between the two

Answer 11

if pCO2 follows HCO3- then metabolic acidosis (with increased anion gap)

if HCO3- follows pCO2 its respiratory alkalosis

Question 12

how is contince achieved in the bladder (sympathetic)

Answer 12

sympathetic innervation from L-centre through hypogastric nerve(T10-L2) stimulates:
beta3=> detruser relaxation
alpha1=> internal urethral sphincter contraction

Question 13

how is contince achieved in the bladder (somatic)

Answer 13

signal from Onuf’s nucles via pudendal nerve(S2-4) => extrenal urethral sphincter contraction

Question 14

what is stress-relaxation phenomenon

Answer 14

relaxation of thedartos massuls with fillingofthe bladder (to a limit) to avoid raise in pressure

Question 15

What are the changhes during micturatoin

Answer 15

sympathetic tone reduced
parasympathetic tone increased=>contraction of dartos stimulated by M3 (fro pelvic nerve)
relaxation of EUS