Acid-Base

Question 1

what is the significance of glutamine in ammonia buffering

Answer 1

glutamine has two ammonia groups that it breaks down and releases in the tubular fluid

Question 2

how does decrease in PaCO2 affect H+ secretion

Answer 2

decreases H+ secretion

Question 3

how does an increase in angiotensin II affect H+ secretion

Answer 3

increases H+ secretion

Question 4

renal compensation for respiratory alkalosis

Answer 4

decrease bicarbonate and decrease acid excretion in the urine

Question 5

pH range of intracellular fluid

Answer 5

6.0-7.4

Question 6

what change in pH is needed to double or half the hydrogen concentration

Answer 6

0.3

Question 7

how does increase in plasma HCO3 affect H+ secretion

Answer 7

decreases H+ secretion

Question 8

what happens to the hydrogen concentration in the ICF in acidemia

Answer 8

increases (takes in H+)

Question 9

what happens to the hydrogen concentration in the ICF in alkalemia

Answer 9

decreases (donates H+)

Question 10

how does a decrease in ECF volume affect H+ secretion

Answer 10

increases H+ secretion

Question 11

what are the two ways ammonia can cross the apical membrane

Answer 11

through an ammonia/Na+ transporter

passively

Question 12

renal compensation for respiratory acidosis

Answer 12

increase bicarbonate and increase acid excretion in the urine

Question 13

how does an increase in ECF volume affect H+ secretion

Answer 13

decreases H+ secretion

Question 14

how does decrease in plasma HCO3 affect H+ secretion

Answer 14

increases H+ secretion

Question 15

how does hypokalemia affect H+ secretion

Answer 15

increases H+ secretion

Question 16

causes of respiratory alkalosis

Answer 16

hypoxia

anxiety (hyperventilation)

progesterone

aspirin poisoning

ventilators

high altitude

Question 17

pH of venous blood and interstitial fluid

Answer 17

7.35

Question 18

how does increase in filtered load of HCO3- affect H+ secretion

Answer 18

increases H+ secretion

Question 19

how does hyperkalemia affect H+ secretion

Answer 19

decreases H+ secretion

Question 20

why is ammonium not a titratable acid

Answer 20

because of the high pK of NH4+ means that no H+ is removed from NH4+ during titration to a pH of 7.4

Question 21

main causes of high anion gap metabolic acidosis

Answer 21

DKA

ethanol

lactic acidosis

opiates

aspirin

Question 22

main causes of non-anion gap metabolic acidosis

Answer 22

diarrhea

spironolactone

post-hypocapnia

Question 23

how does bicarbonate help carry Na+ out of the cell and into the blood in the proximal tubule

Answer 23

through the HCO3-/Na+ symporter - passively diffuses to promote Na+ transport

Question 24

3 ways in which CO2 is transported

Answer 24

7% dissolved

23% w/ hemoglobin

70% as bicarbonate

Question 25

respiratory and renal compensation for metabolic alkalosis

Answer 25

hypoventilation, or longer breaths decrease bicarbonate regeneration and decrease acid excretion in urine

Question 26

pH of arterial blood

Answer 26

7.40

Question 27

main causes of metabolic alkalosis

Answer 27

vomiting licorice post-hypercapnia diuretics hyperaldosteronism loop or thiazide diuretics

Question 28

what is net acid excretion made of

Answer 28

1/3: titratable acids (primarily phosphate and salts with a pka \< 7.4) 2/3: NH4+

Question 29

where is bicarbonate reabsorbed

Answer 29

85% PCT 10% TAL 4.9% CT 0.1% urine

Question 30

respiratory and renal compensation for metabolic acidosis

Answer 30

hyperventilation increase bicarbonate regeneration and increase acid excretion in the urine

Question 31

how does increase in PaCO2 affect H+ secretion

Answer 31

increases H+ secretion