Acid-base regulation Flashcards

(32 cards)

1
Q

what is the henderson-hasselbalch equation for the bicarbonate buffer system?

A

pH = 6.1 + log [HCO3-] / (0.03) x PCO2)

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2
Q

what largely determines blood pH?

A

RATIO of bicarbonate ion to dissolved CO2

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3
Q

how does the kidney regulate acid-base biochemistry?

A
  • H+ excretion

- bicarb reabsorption

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4
Q

how are protons removed from the body?

A
  • filtered buffers (phosphate buffers)

- binding to NH3 (NH4+)

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5
Q

what transporter proteins are located at the PCT?

A
  • luminal Na/H exchanger (protons into lumen)

- basolateral Na/K ATPase (3 Na reabsorbed, 2 K into cell)

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6
Q

what transporter protein is located at the DCT?

A

proton ATPase (protons into lumen)

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7
Q

what happens at the DCT in response to low pH?

A

insertion of ATPase into luminal membrane (more protons enter tubular fluid)

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8
Q

what % of bicarb is reabsorbed at the PCT? what % is reabsorbed at the collecting tubule?

A
  • 90% at PCT

- 10% at collecting tubule

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9
Q

what are the steps of bicarb reabsorption at the PCT? what is the net effect?

A
  • protons secreted into tubule lumen
  • reacts with bicarb in filtrate, forming carbonic acid
  • carbonic anhydrase converts carbonic acid to water and CO2
  • water and CO2 diffuse into renal tubular cell
  • carbonic anhydrase converts water and CO2 to carbonic acid
  • carbonic acid dissociates, protons exported to tubule lumen and bicarb exported to blood

NET EFFECT: movement of NaHCO3 from filtrate to blood

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10
Q

what are the steps of bicarb reabsorption at the collecting duct? what is the net effect?

A
  • formation of carbonic acid in tubular lumen
  • water and CO2 re-enter tubular cell
  • carbonic acid is re-made in tubular cell
  • dissociation to bicarb and proton in tubular cell
  • bicarb reabsorbed by a chloride-bicarb transporter

pumping out proton, which forms carbonic acid, acted upon by carbonic anhydrase, CO2 and water are taken back up

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11
Q

what is the difference between bicarb reabsorption betwee nthe PCT and collecting duct?

A
  • different way to put proton in the tubular lumen

- different pump putting bicarb back into system

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12
Q

where are beta intercalated cells located? what is special about them?

A
  • collecting duct

- reverse polarity of membrane transporters

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13
Q

what are the transporters in beta intercalated cells?

A
  • HCO3 / Cl

- H+ ATPase

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14
Q

what is the limiting urine pH? what cant it be lower?

A

4.4

the proton translocator cannot pump any more protons into lumen

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15
Q

what is the main non-bicarb urinary buffer? what form is excreted?

A
  • phosphate

- H2PO4 -

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16
Q

the ability to excrete protons as H2PO4 - is limited by:

A
  • amount of HPO4 in filtrate

- requirement of body to retain phosphate

17
Q

for each newly formed H2PO4 excreted into the urine, what happens to 1) proton, and 2) bicarb?

A
  • one proton eliminated

- one new bicarb formed and added to the blood

18
Q

where in the kidney does ammonia formation occur?

19
Q

what enzyme is expressed by the kidney allowing it to convert glutamine to glutamate?

20
Q

what happens to glutamate after being converted from glutamine from glutaminase? what is the net effect?

A

converted to a-ketoglutarate and ammonia by glutamate dehydrogenase

NET EFFECT: ammonia exported to tubular lumen, bicarb released to the blood - excretion of protons into the lumen and addition of NEW molecules of bicarb to the blood

21
Q

how many bicarb ions are formed from glutamate?

22
Q

what happens to ammonia excretion in repose to increased urine acidity?

A

rapid increase

23
Q

the rate of proton secretion is dependent on _____

24
Q

what does a reduced pH do to the Na/H antiporter and H+ ATPase?

25
what happens to ammonia formation during acidosis?
increase
26
what happens to 1) glutamine uptake / glutaminase activity, and 2) ammonia excretion during acidosis?
increase
27
during alkalosis, proton secretion is _________ (sufficienct / insufficient) to allow bicarb reabsorption
insufficient
28
what happens to bicarb during alkalosis?
excreted in urine
29
what is the effect of beta intercalated cells during alkalosis?
actively SECRETE bicarb into tubular lumen
30
how is arterial bicarb calculated?
- from concentration of CO2 and pH
31
what is the equation for anion gap?
[Na]plasma - ([HOC3]plasma + [Cl-]plasma)
32
what is base excess or deficit (delta base)?
difference between measured [HCO3-] and [HCO3-] predicted by the normal buffer slope at that pH