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Physio II > Acid Base Balance > Flashcards

Acid Base Balance Flashcards

1
Q

Describe what metabolic acid-base alterations can lead to.

A
  1. Altered CVS function
  2. Altered neuro function
  3. Altered resp function
  4. Altered response to drugs
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2
Q

Describe the effect of pH in the body.

A

-altered H ion conc affect structure of proteins, function of enzymes, receptors, transport proteins, channels, etc
-constant pH needed for cell function
-abnormal H conc = adverse effect on function of all organ systems
>conc of H ions in ECF must be equal (acid base regulation)

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3
Q

Describe buffers.

A

-maintain pH
-reversibly binds free H+ ions in solutions
-intracellular & extracellular buffer systems
-2 organs help maintain pH = lungs & kidneys

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4
Q

Describe acids VS base.

A

Acid = donates H
>H+
>made by metabolic processes
Base = accepts H
>HCO3-
>derived from nutrients
*protons are pos

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5
Q

Describe volatile VS nonvolatile acids.

A

Volatile:
-CO2 & H2O
-can breathe out
Nonvolatile:
-acids generated as byproducts of metabolism (kidneys)

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6
Q

Describe pH.

A

-measure of alkalinity & acidity
-proton conc [H+] in a solution & pH are inversely related
(High pH = low H+)
*pH equal to neg log of H+
*blood pH = 7.4

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7
Q

Describe the Henderson hasselbach equation.

A

-relationship between pH & mixture of an acid & its conjugate base
-evaluates pH by partial pressure of CO2 & bicarbonate HCO3
*increase HCO3 -> increase pH -> alkalosis
*increase PCO2 -> decrease pH -> acidosis

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8
Q

Describe strong VS weak acids & bases.

A

-strong acid = dissociates & releases H+ (ex. HCl)
-weak acid = releases H+ less easily (ex. H2CO3)
-strong base = reacts w H+ & removes H+ quickly (ex. OH)
-weak base = reacts slow w H+ (ex. HCO3)
*acids & bases in ECF are weak = H2CO3 & HCO3

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9
Q

Describe alkali.

A

-formed by combination of alkaline metals with a basic ion (OH)
-soluble base (soluble in water = contains alkaline metal)

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10
Q

Describe buffer solution.

A

-mixture of weak acid & conjugate base
-mixture of weak base & conjugate acid
-dissociation constant (pK) = pH at which half the buffer substance is dissociated & half is undissociated

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11
Q

Describe the pH differences in ECF & ICF.

A

-intracellular (ICF) pH is lower than plasma pH (ECF)
-cells under ischemia = more acidic pH

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12
Q

Describe the 3 systems that regulate H+ & HCO3- conc & pH in the body.

A

-buffer system (secs) = phosphate, proteins, bicarb
-lungs (mins) = CO2
-kidneys (hrs/days) = excrete/reabsorb H+ & HCO3-

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13
Q

Describe bicarbonate, phosphate, & protein buffer system.

A
  1. Bicarbonate (ECF)
    -if the conc of H+/H2CO3 decreases = more H+ & HCO3 made & CO2 levels reduced
    -decrease respiratory rate
  2. Phosphate (ICF)
    -NaHPO4, HPO4
  3. Proteins (ECF & ICF)
    -accept protons like ex. Hemoglobin
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14
Q

Describe intracellular buffers.

A

-amino acids, proteins, phosphate
-membrane carriers:
>Na/H exchanger
>Cl/HCO3 exchanger

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15
Q

Describe respiration & acid base regulation.

A

-increased ventilation = increase CO2 elimination & decreased H+ conc (left shift, pH increases)
>hyperventilation = respiratory alkalosis
-changes in blood pH helps mitigate by increasing/decreasing rate of alveolar ventilation
>decrease in plasma pH = increase ventilation rate
*non volatile acids cant be excreted by lungs

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16
Q

Describe the kidneys.

A

-if H+ excretion > HCO3 excretion = acid loss from ECF

17
Q

What are the 4 factors that control bicarbonate reabsorption?

A
  1. Luminal HCO3 conc
  2. Luminal flow rate
  3. Arterial pCO2
  4. Angiotensin II
18
Q

Describe secretion & reabsorption.

A
  1. H+ secretion requires: (apical)
    -Na/H anti porter
    -H+ ATPase (proton pump)
  2. HCO2 reabsorption requires: (basolateral)
    -HCO3/Na cotransporter
    -HCO3/Cl antiporter
    *H+ excretion implies HCO3 reabsorption
19
Q

Describe renal regulation of acids & bases.

A
  1. Acidosis = high H+ promote reabsorption of HCO3 & excess H+ excreted into urine
  2. Alkalosis = excess HCO3 not reabsorbed and excreted into urine
20
Q

Describe intercalated cells functions.

A
  1. Acidosis (Type A) = IC cells secrete H+ & reabsorb HCO3
  2. Alkalosis (Type B) = IC cells reabsorb H+ & eliminate HCO3
21
Q

What happens to the excess H+ in the tubular lumen?

A

-excretion of H+ via phosphate & ammonia

22
Q

Describe the relationship between hypokalemia & acid base disturbances.

A
  1. Type B alkalosis (high pH)
    -hypokalemia = decrease conc of K+ in ECF
    >impaired neural transmission & muscle weakness
  2. Type A acidosis (low pH)
    -hyperkalemia = increase conc of K+ in ECF
    >interfere w membrane potential -> cardiac toxicity
    H+ elimination means K+ reabsorption & vice versa
23
Q

Describe metabolic acidosis.

A

-gain in acid or loss of base
-decrease pH from acid accumulation that consume HCO3 or loss of HCO3
-compensatory = decrease PCO2 via hyperventilation
(Hyperkalemia)

24
Q

Describe metabolic alkalosis.

A

-gain in base or loss of acid
-increased pH by loss of acid or increased HCO3
-compensatory = increased PCO2 via hypoventilation
(Hypokalemia)

25
Q

Describe respiratory acidosis.

A

-decreased pH & increased PCO2
-compensatory = increase in HCO3 via kidneys
(Hypoventilation)

26
Q

Describe respiratory alkalosis.

A

-increased pH & decreased PCO2
-compensatory = decrease in HCO3
(Hyperventilation)

27
Q

Describe the 3 parameters needed for analyzing acid base status.

A

-pH of blood
-pCO2
-standard bicarb

28
Q

Describe the anion gap (AG).

A

-eval acid base disorders
-characterize metabolic acidosis
>increased AG (normochloremic) metabolic acidosis
>normal AG (hyperchloremic) metabolic acidosis
-electroneutrality
>UA = unmeasured anions like organic acids
>UC = unmeasured cations like Ca & Mg
*either increase UA or Cl-
*AG increases if UA increase (>16) or UC decreases

29
Q

Clinical cases diagram!

A

Physio II (13 decks)

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