Acid-Base Balance

Question 1

acid-base balance is one of the most important of the body’s ____ mechanisms

Answer 1

homeostatic

Question 2

acid-base balance refers to regulation of ___ ion concentration in the body

Answer 2

hydrogen

Question 3

precise regulation of pH at the ___ level is necessary for survival

Answer 3

cellular

Question 4

slight pH changes have dramatic effects on ____ metabolism

Answer 4

cellular

Question 5

acid base balance is achieved by utilization of ___ buffers in the extracellular and intracellular fluids

Answer 5

chemical

Question 6

acid base balance is achieved by ___ mechanisms that excrete ___

Answer 6

respiratory

CO2

Question 7

acid base balance is achieved by ____ mechanisms that reabsorb ___ and secrete ___ ions

Answer 7

renal
bicarbonate
hydrogen

Question 8

normal range of arterial pH is ___-___

Answer 8

7.37 - 7.42

Question 9

acid production in the body (2)

Answer 9

CO2

fixed acid

Question 10

CO2 is the end product of ___ metabolism; ____ acid

Answer 10

aerobic

volatile

Question 11

CO2 is a volatile acid because it is the end product of the catabolism of ____ ___

Answer 11

carbonic acid

Question 12

carbonic acid breaks into ___ and __

Answer 12

CO2 and water

Question 13

fixed acid is a ___ acid

Answer 13

non-volatile

Question 14

4 examples of fixed acids

Answer 14

phosphate
phosphoric acid
sulfuric acid
lactate acid

Question 15

___ are substances that prevent marked change in pH of solution when an acid or base is added to it

Answer 15

buffers

Question 16

buffers consist of ___ acid and basic ___ of that acid

Answer 16

weak

salt

Question 17

buffer pairs present in body fluids - 4 acids and 2 salts

Answer 17

• carbonic acid
• proteins
• hemoglobin
• acid phosphate
• sodium
• potassium

Question 18

nonvolatile acids buffered mainly by ____ ___

Answer 18

sodium bicarbonate

Question 19

volatile acids buffered mainly by ___ ___ of ___ and ___

Answer 19

potassium salts
hemoglobin
oxyhemoglobin

Question 20

the chloride shift makes it possible for carbonic acid to be buffered in ___ and then carried as ___ in the plasma

Answer 20

RBC

bicarbonate

Question 21

bases are buffered mainly by ___ ___

Answer 21

carbonic acid

Question 22

___-___ equation is a mathematical formula that explains the relationship between hydrogen ion concentration of body fluids and the ratio of base bicarbonate to carbonic acid

Answer 22

Henderson-Hasselbalch

Question 23

strong acid/base dissociates to a __ acid/base to prevent marked change pH

• ex HCl + NaHCO3 –> HHCO3 + NaCl
• ex NaOH + HHCO3 –> NaHCO3 + HOH

Answer 23

weak

Question 24

mechanism of Hydrogen ion regulation

- body fluid chemical buffers (4)

Answer 24

bicarbonate
proteins
ammonia
phosphate

Question 25

mechanism of Hydrogen ion regulation - lungs - - increase H+ concentration --> ___ ventilation --> increase CO2 ____

Answer 25

increase | loss

Question 26

mechanism of Hydrogen ion regulation - kidneys - - secretes ___ - - reabsorbs ____ - - generates new ___

Answer 26

H+ bicarbonate bicarbonate

Question 27

hydrogen regulation by body fluid chemical buffers occurs ___ but ___

Answer 27

rapidly | temporary

Question 28

hydrogen regulation by the lungs is ___ and eliminates ___

Answer 28

rapid | CO2

Question 29

hydrogen regulation by the kidney is ___, ___ and eliminates ___ ___

Answer 29

slow powerful non-volatile acids

Question 30

___ is the most important extracellular fluid buffer

Answer 30

bicarbonate

Question 31

___ and ___ are the important renal tubular buffers

Answer 31

phosphate | ammonia

Question 32

___ are important intracellular buffers

Answer 32

proteins

Question 33

__-__% of buffering is int he cells

Answer 33

60-70

Question 34

effectiveness of buffer system depends on - ___ of reactants - ___ of system and ___ of body fluids

Answer 34

concentration | pK; pH

Question 35

increase [H+] --> ___ alveolar ventilation --> ___ pCO2 --> ____ [H+]

Answer 35

increase decrease decrease

Question 36

urinary mechanism - reabsorption of ___ - excretion of fixed H+ produced from __ and __ catabolism

Answer 36

HCO3- | protein; phospholipid

Question 37

bicarbonate in the lumen is broken down and brought into the cell as its end products - ___ is exchanged with Na+ into the lumen - bicarbonate is broken down and ___ and ___ diffuses into the cell

Answer 37

H+ CO2 H20

Question 38

filtered HCO3- is reabsorbed into the blood by: - ___ with Na+ - ___ with Cl-

Answer 38

symporter | antiporter

Question 39

bicarbonate is broken down to CO2 and H20 by ___ ___

Answer 39

carbonic anhydrase

Question 40

excess HCO3- ____ the reabsorptive capacity

Answer 40

exceeds

Question 41

ECF volume expansion ___ HCO3- reabsorption

Answer 41

inhibits

Question 42

ECF volume contraction ___ HCO3- reabsorption

Answer 42

stimulates

Question 43

ECF volume uses the ___ ___ mechanism

Answer 43

angiotensin II

Question 44

increase in pCO2 --> ___ in HCO3- reabsorption

Answer 44

increase

Question 45

increase glutamine metabolism --> NH3 + H+ --> NH4 --> excreted to the lumen from the ___ cell --> HCO3- is __

Answer 45

intercalated reabsorbed H+ is excreted as NH4

Question 46

acidosis ___ glutamine metabolism

Answer 46

increase

Question 47

hyperkalemia ___ NH3 synthesis, causing type 4 renal tubular acidosis

Answer 47

inhibits

Question 48

hypokalemia ___ NH3 synthesis

Answer 48

stimulates

Question 49

acidosis ___ ammonia synthesis

Answer 49

stimulates

Question 50

``` tritratable acid (H2PO4) = HPO4- + H+ from ___ acid catabolism ```

Answer 50

carbonic

Question 51

metabolisc acid base disorders | - primary disorders involving ___

Answer 51

HCO3-

Question 52

respiratory acid base disorders | - primary disorders involving ___

Answer 52

CO2

Question 53

___ ____ ___: a measurement useful in diagnosis of acid-base disorders; based on electronegativity

Answer 53

plasma anion gap

Question 54

normal range of plasma anion gap

Answer 54

8-16mEq/L

Question 55

main cation = ___

Answer 55

Na+

Question 56

main anion is ___

Answer 56

Cl-

Question 57

anion gap is hard to ___

Answer 57

measure

Question 58

plasma anion gap is useful primarily in the differential diagnosis of ___ diagnosis

Answer 58

metabolic

Question 59

if HCO3- is replaced by unmeasured anions, the calculated anion gap is ___

Answer 59

increased

Question 60

if HCO3- is replaced by Cl-, the calculated anion gap is ___

Answer 60

normal

Question 61

plasma anion cap = ___ - ___ - ____

Answer 61

[Na+] - [HCO3-] - [Cl-]

Question 62

in body fluids | - total cations ___ total anions

Answer 62

equals

Question 63

metabolic acidosis with increased anion gap due to 6 things

Answer 63

``` diabetic ketoacidosis lactic acidosis salicylate poisoning methanol poisoning ethylene glycol poisoning chronic renal failure ```

Question 64

metabolic acidosis with increased anion gapdue to the accumulation of ____ and ___ acids

Answer 64

non-volatile | organic

Question 65

metabolic acidosis with normal anion gap due to 2 things

Answer 65

diarrhea | renal tubular acidosis

Question 66

metabolic acidosis with normal anion gap there is ___ ___ anion accumulation

Answer 66

no organic

Question 67

increase in HCO3 due to acidosis leads to - slight ___ of tritratable acid - ___ NH4 excretion - ___ HCO3 excretion

Answer 67

increase increase decrease

Question 68

loss of HCO3 due to alkalosis leads to a - ___ of tritratable acid - ___ NH4 excretion - ___ HCO3 excretion

Answer 68

decrease decrease increase

Question 69

HCO3 excretion can ___ markedly in ___

Answer 69

alkalosis

Question 70

acidosis : - pH ___ 7.4 - metabolic: ___ HCO3- - respiratory: ___ pCO2

Answer 70

< decrease increase

Question 71

alkalosis: - pH ___ 7.4 - metabolic: ___ HCO3- - respiratory: ___ pCO2

Answer 71

> increase decrease

Question 72

acidosis: - ___ H+ excretion - ___ HCO3- reabsorption - production of new ____

Answer 72

increased increased HCO3-

Question 73

alkalosis: - ___ H+ excretion - ___ HCO3- reabsorption - loss of ___ in urine

Answer 73

decreased decreased HCO3-

Question 74

respiratory acidosis - ___ pH - ___ pCO2 - ___ HCO3-

Answer 74

decrease increase increase

Question 75

respiratory acidosis - Increased pCO2 --> ___ H+ secretion --> ___ HCO3- reabsorption --> ___ tubular H+ --> ___ H+ buffers and __ new HCO3 --> ___ pH

Answer 75

``` increase complete excess increase increase increase ```

Question 76

metabolic acidosis - ___ pH - ___ pCO2 - ___ HCO3-

Answer 76

decrease decrease decrease

Question 77

metabolic acidosis - decreased HCO3- --> ___ H+ filtration --> ___ HCO3- reabsorption --> ___ tubular H+ --> ___ H+ buffers and __ new HCO3 --> ___ pH

Answer 77

``` decreased complete excess increase increase increase ```

Question 78

respiratory alkalosis - ___ pH - ___ pCO2 - ___ HCO3-

Answer 78

increase decrease decrease

Question 79

respiratory alkalosis - decreased pCO2 --> ___ H+ secretion --> ___ HCO3- reabsorption --> ___ tubular HCO3- --> ___ HCO3- excretion and __ H+ excretion --> ___ pH

Answer 79

``` decrease decrease excess increase decrease decrease ```

Question 80

metabolic alkalosis - ___ pH - ___ pCO2 - ___ HCO3-

Answer 80

increase increase increase

Question 81

metabolic alkalosis - increased HCO3- --> ___ HCO3- filtration --> ___ tubular HCO3- --> ___ HCO3- reabsorption --> __ HCO3- excretion and __ H+ excretion --> ___ pH

Answer 81

``` increase excess decrease increase decrease decrease ```

Question 82

compensation for metabolic acidosis - ___ ventilation - ___ renal HCO3 production

Answer 82

increase | increase

Question 83

compensation for respiratory acidosis - ___ ventilation - ___ renal HCO3 production

Answer 83

NO | increase

Question 84

compensation for metabolic alkalosis - ___ ventilation - ___ renal HCO3 production

Answer 84

decrease | increase

Question 85

compensation for respiratory alkalosis - ___ ventilation - ___ renal HCO3 production

Answer 85

NO | increase

Question 86

primary distrubance for metabolic acidosis

Answer 86

decrease HCO3-

Question 87

compensation for metabolic acidosis

Answer 87

decrease pCO2 by increase ventilation

Question 88

primary disturbance for metabolic alkalosis

Answer 88

increase HCO3-

Question 89

compensation for metabolic alkalosis

Answer 89

increase pCO2 by decrease ventilation

Question 90

primary disturbance for respiratory acidosis

Answer 90

increase pCO2

Question 91

compensation for respiratory acidosis

Answer 91

increase HCO3-

Question 92

primary disturbance for respiratory alkalosis

Answer 92

decrease pCO2

Question 93

compensation for respiratory alkalosis

Answer 93

decrease HCO3-

Question 94

respiratory acidosis caused by 4 things

Answer 94

brain damage pneumonia emphysema other lung disorders

Question 95

metabolic acidosis caused by 4 things

Answer 95

increased base intake vomiting gastric acid mineralocorticoid excess overuse of diuretics

Question 96

increase aldosterone --> ___ tubular K+ secretion --> K+ ___ --> ___ H+ secretion --> ___ HCO3 reabsorption and __ new HCO3 production --> ___ ___

Answer 96

``` increase depletion increase increase increase metabolic alkalosis ```

Question 97

respiratory alkalosis due to 2 things

Answer 97

high altitude | psychic