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Acid/ Base Balance Flashcards

(67 cards)

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1
Q

What is the normal pH of arterial blood?

A

7.4

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2
Q

What ion does the body produce?

A

H ions

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3
Q

Name 2 sources of H in the body?

A

Respiratory acids

Metabolic acids

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4
Q

An increase in acidic conditions will do what to ventilation?

A

Increase (breath off CO2)

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5
Q

What is a metabolic form of acid?

A

lactic acid

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6
Q

On a normal day, what is the net gain of H in the body?

A

50-100mmoles

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7
Q

What minimises changes in pH?

A

Buffers

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8
Q

What equation defines the pH in terms of ratio A/HA?

A

Henderson-Hasselbalch equation

pH = pK + log (A/HA)

pH §(HCO3)/pco2

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9
Q

What is the most important ECF buffer?

A

Bicarbonate

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10
Q

What is the ratio of bicarbonate to carbonic acid in the body?

A

20:1

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11
Q

What is the standard HCO level in the body?

A

24 mmoles (22-26)

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12
Q

What is the normal PCO?

A

40mmHg

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13
Q

If there is a reduction in H ions, what will happen to ventilation?

A

Reduce

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14
Q

How is H eliminated from the body?

A

From the kidneys

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15
Q

What is {HCO} regulated by?

A

Kidneys

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16
Q

What is PCO controlled by?

A

Lungs

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17
Q

What is exchanged for H moving into the cell? Why?

A

K ions

To maintain electrical neutrality

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18
Q

In acidosis, what can occur to the ECF?

A

Increase in K (hyperkalaemia)

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19
Q

How do the kidneys regulate HCO?

A

Reabsorb filtered HCO

Generate new HCO

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20
Q

What does the reabsorption & generation of new HCO depend on?

A

Active H secretion from tubule into lumen

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21
Q

In what form does HCO move across the cell membrane?

A

CO2

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22
Q

What is the name of the enzyme responsible for the conversion of CO > H2CO3?

A

Carbonic anhydrase

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23
Q

What passes into the peritubular kidneys?

A

Na & HCO3

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24
Q

Where does the bulk of HCO reabsorption occur?

A

Proximal tubule

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25
How much HCO is filtered per day?
4320mmoles
26
How is H ions actively moved across the tubular membrane into the lumen?
Na/H antiporter
27
What is the minimum and maximum urine pH?
4. 5 | 8. 0
28
What weak acids/ bases act as buffers?
uric acid creatinine dibasic phosphate
29
What is the importance of formation of titratable acidity?
Generates new HCO and excretes H
30
In titratable acidity, what molecule is responsible foe excreting H ions?
HPO4 (mono basic phosphate)
31
When HCO is reabosorbed, is H lost?
No excretion of H
32
Where does the process of titratable acidity occur? When?
Distal tubule | Acid overload
33
What is the major adaptive response to acid load?
Ammonium excretion
34
What does ammonium excretion generate?
Generates new HCO | Excretes H
35
When is ammonium excretion used?
Only for acid load
36
What are the properties of NH3+?
Lipid soluble
37
What does NH3+ combine with in the lumen?
H | Cl
38
What enzyme is responsible for the deamination of glutamine to form NH3?
Renal glutamine
39
What is the net outcome of ammonium excretion?
H secretion | Generation of new HCO
40
In the proximal tubule, the presence of which symporter allows NH4 to move into the lumen?
NH4/NA symporter
41
When ICF pH falls, what happens to renal glutamine activity?
Increases
42
How long does it take the kidneys to adapt to changes in pH?
4-5 days
43
A decrease in body pH is called??
Acidosis
44
An increase in body pH is called?
Alkalosis
45
Respiratory disorders affect what?
PCO2
46
Renal disorders affect what?
HCO
47
A reduction in ventilation would lead to CO2 retention and....
Respiratory Acidosis
48
Name a cause of acute respiratory acidosis
Drugs - opiates & barbituates
49
Name a change of chronic respiratory acidosis
Chronic bronchitis/ emphysema, asthma
50
When an increase in ventilation is observed and CO2 is blown off...... occurs.
Respiratory alkalosis
51
An acute cause of respiratory alkalosis is...
Voluntary hyperventilation | First ascent to altitude
52
A chronic cause of respiratory alkalosis is .....
Long term residence at altitude (inc ventilation due to < PO)
53
What are some of the causes of metabolic acidosis?
Diabetic ketoacidosis | Loss of HCO in diarrhoea
54
What is the name of a state of hyperventilation observed during diabetic ketoacidosis?
Kussmaul breathing
55
What are some of the causes of metabolic alkalosis?
``` Vomiting Aldosterone excess ( H loss) ```
56
A decrease in pH can be caused by either:
A decrease in HCO | Increase in PCO
57
An increase in pH can be caused by:
An increase in HCO | Decrease PCO
58
In acidosis, what happens to K levels?
Hyperkalaemia
59
What does insulin do to K ?
Stimulates cellular uptake
60
In hypovolaemia, aldosterone is secreted and acts on which tansporters at the lumen?
Na transporter (in) H (out) K (out)
61
What does excess ingestion of liquorice precipitate?
Metabolic alkalosis
62
What are cations?
Na & K
63
What are anions?
Cl & HCO
64
The following blood gas values were seen in a patient. Which simple Acid/Base Disturbance has he got? pH = 7.32, [HCO-3]= 15 mM, PCO2 = 30mmHg (4kPa)
Metabolic acidosis
65
The following blood gas values were seen in a patient. Which simple Acid/Base Disturbance has he got? pH = 7.32, [HCO-3]= 33 mM, PCO2 = 60mmHg (8kPa)
Chronic respiratory Acidosis
66
The following blood gas values were seen in a patient. Which simple Acid/Base Disturbance has he got? pH = 7.45, [HCO-3] = 42 mM, PCO2 = 50mmHg (6.7kPa)
Metabolic Alkalosis
67
The following blood gas values were seen in a patient. Which simple Acid/Base Disturbance has he got? pH = 7.45, [HCO-3]= 21 mM, PCO2 = 30mmHg (4kPa)
Respiratory Alkalosis (acute)

Urinary (17 decks)

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