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Y2 Renal > Acid Base Balance > Flashcards

Acid Base Balance Flashcards

1
Q

what is the average pH of blood?

A

7.4

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2
Q

what is the pH of ECF?

A

7.4

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3
Q

what effect can acidosis have on the CNS?

A

depression of the CNS

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4
Q

what effect can alkalosis have on the nervous system?

A

over excitability

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5
Q

how can the kidneys control plasma bicarbonate concentration?

A

reabsorb HCO3

can add new HCO3 to the blood

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6
Q

what does kidney control of bicarbonate concentration depend on?

A

hydrogen secretion into the tubule

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7
Q

how much hydrogen is filtered into the tubular fluid at normal pH?

A

very few

there aren’t many in the plasma

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8
Q

what cells secrete hydrogen ions into the filtrate?

A

proximal tubule
distal tubule
collecting duct

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9
Q

how much bicarbonate is present in normal filtrate?

A

a lot - as they are freely filtered

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10
Q

how are bicarbonate ions taken up by tubular cells?

A

combine with hydrogen in the tubular fluid to form carbonic acid, dissociates into CO2 and H2O which enter the cell by diffusion

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11
Q

what transporter secretes hydrogen ions into the tubular fluid normally?

A

the sodium hydrogen anti-porter

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12
Q

how is bicarbonate moved out of the tubular cell into the interstitial fluid?

A

H2O + CO2 reform carbonic acid, dissociates into bicarbonate + H

leaves by the sodium bicarbonate co transporter

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13
Q

when bicarbonate in the tubular fluid is low due to buffering an acidosis, what is the next most plentiful buffer available?

A

phosphate

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14
Q

how does phosphate act as a buffer in the tubular fluid?

A

binds to hydrogen ions forming an acid phosphate which is excreted from the body in the urine

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15
Q

what acts as a buffer in acidosis when all bicarbonate and phosphate has been used up?

A

ammonia

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16
Q

how does ammonia act as a tubular buffer?

A

combines with hydrogen to form ammonium ions which are excreted in urine

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17
Q

how is ammonia formed?

A

metabolism of glutamine (amino acid) by glutaminase to form ammonia

18
Q

what is compensation?

A

restoration of pH regardless of what happens to bicarbonate and pCO2

19
Q

what is correction of an AB disturbance?

A

restoration of pH, bicarbonate and pCO2 to normal

20
Q

how can a blood gas analysis be visualised and plotted?

A

on a davenport diagram

21
Q

what is a respiratory acidosis?

A

retention of CO2 by the body

22
Q

name three possible causes of respiratory acidosis

A

chronic bronchitis
chronic emphysema
chest injuries

23
Q

what does a respiratory acidosis cause?

A

rise in H+ and HCO3

24
Q

when is it classified as an uncompensated respiratory acidosis?

A

pH <7.35

pCO2 >45

25
Q

how is a respiratory acidosis compensated?

A

by the kidneys

CO2 retention stimulates H+ secretion into the filtrate = excreted

all bicarbonate reabsorbed

produces bicarbonate and excretes phosphate + ammonium

26
Q

how is a respiratory acidosis corrected?

A

restoring normal ventilation

27
Q

what is a respiratory alkalosis?

A

excessive removal of CO2 by the body

28
Q

name two possible causes of respiratory alkalosis

A

altitude

hyperventilation

29
Q

what happens as a result of a respiratory alkalosis?

A

hydrogen and bicarbonate concentrations fall

30
Q

what indicates an uncompensated respiratory alkalosis?

A

pH >7.45

PCO2 <35

31
Q

how is a respiratory alkalosis compensated?

A

bicarbonate excreted in the urine

no more bicarbonate generated

reduced H+ secretion

32
Q

how is a respiratory alkalosis corrected?

A

restoration of normal ventilation

33
Q

what is a metabolic acidosis?

A

excess H+ from any source other than CO2

34
Q

what indicates an uncompensated metabolic acidosis?

A

pH <7.35

low HCO3

35
Q

how is a metabolic acidosis compensated?

A

ventilation increased to blow off more CO2

36
Q

how is a metabolic acidosis corrected?

A

more bicarbonate generated by the kidneys and acidic urine excreted

normalise ventilation

37
Q

what is metabolic alkalosis?

A

excessive loss of H+ from the body

38
Q

what indicates an uncompensated metabolic alkalosis?

A

pH >7.45

high HCO3

39
Q

how is a metabolic alkalosis compensated?

A

slowed ventilation to retain. CO2

40
Q

how is a metabolic alkalosis corrected?

A

HCO3 excreted and no more generated

falls to normal

Y2 Renal (29 decks)

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