Diabetes Mellitus

Question 1

What is the role of the kidneys and lungs in maintaining acid-base balance?

Answer 1

The kidneys regulate bicarbonate levels and excrete H+ ions, while the lungs control CO2 levels through respiration.

Question 2

What is the relationship between [H+] and pH?

Answer 2

pH = -log10[H+]. Low pH indicates high [H+] (acidosis), while high pH indicates low [H+] (alkalosis).

Question 3

What are the normal [H+] levels in the body?

Answer 3

Normal [H+] level: 35 - 45 nmol/L.

Question 4

Why is it important for the body to maintain pH?

Answer 4

To alter the structure and functions of proteins, ensure specific [H+] for enzyme activity, affect biological activity of cations, and influence molecular movement in cells.

Question 5

What are the sources of H+ ions in the body?

Answer 5

Metabolic acids from anaerobic metabolism and respiratory acids from CO2.

Question 6

What are the three mechanisms the body uses to control [H+]?

Answer 6

• Buffering system
• Respiratory system
• Renal system

Question 7

What is the buffering system in the body?

Answer 7

It includes carbonic acid-bicarbonate, protein, and phosphate buffers that respond immediately to pH changes.

Question 8

What is the normal plasma [HCO3-] level?

Answer 8

Normal plasma [HCO3-] is 24 mmol/L.

Question 9

What is the bicarbonate-carbonic acid buffer equation?

Answer 9

H+ + HCO3- ⇌ H2CO3 ⇌ CO2 + H2O.

Question 10

What is the primary function of the kidneys in acid-base balance?

Answer 10

The kidneys control bicarbonate levels by recovering and regenerating HCO3- and excreting H+.

Question 11

What is the role of erythrocytes in respiratory regulation of acid-base balance?

Answer 11

Erythrocytes transport CO2 as bicarbonate and play a role in buffering H+ ions.

Question 12

How is arterial blood gas analysis performed?

Answer 12

Blood is collected in a syringe with anticoagulant, transported on ice, and analyzed for [H+] and pCO2.

Question 13

What do the three readings from arterial blood gas analysis indicate?

Answer 13

• [H+]
• pCO2
• [HCO3-]

Question 14

What are the types of acid-base disorders?

Answer 14

• Respiratory acidosis
• Respiratory alkalosis
• Metabolic acidosis
• Metabolic alkalosis

Question 15

What is full compensation in acid-base balance?

Answer 15

Full compensation occurs when pH is restored to normal, while [H+] remains abnormal.

Question 16

What is the difference between respiratory and metabolic compensation?

Answer 16

• Respiratory compensation: alteration in pCO2 (quick response)
• Metabolic compensation: alteration in [HCO3-] (slower response)

Question 17

Fill in the blank: Increased H+ formation in metabolic acidosis can be caused by _______.

Answer 17

[ketoacidosis, lactic acidosis, poisoning, inherited organic acidosis]

Question 18

What are common clinical presentations of metabolic acidosis?

Answer 18

• Hyperventilation
• Neuromuscular irritability
• CNS depression

Question 19

What causes metabolic alkalosis?

Answer 19

• Gastrointestinal loss of H+
• Renal loss of H+
• Alkali ingestion

Question 20

What is a common clinical presentation of respiratory acidosis?

Answer 20

• Confusion
• Coma
• Headaches

Question 21

True or False: Acute respiratory acidosis results from hyperventilation.

Answer 21

False.

Question 22

What are the two ways mixed acid-base disorders can present?

Answer 22

• Severe acidaemia or alkalaemia
• Normal or near normal H+ with abnormal pCO2 and bicarbonate

Question 23

What is the significance of the chloride shift in acid-base balance?

Answer 23

It facilitates the transport of CO2 in the form of bicarbonate in plasma.

Question 24

What happens during renal compensation in metabolic acidosis?

Answer 24

The kidneys excrete more HCO3- and form NH4+.

Question 25

What is the expected response of the lungs in metabolic acidosis?

Answer 25

Respiratory compensation through hyperventilation to reduce pCO2.

Question 26

What is the expected change in pH during metabolic alkalosis?

Answer 26

pH > 7.45.

Question 27

What are the key components to check when interpreting acid-base disorders?

Answer 27

* Check [H+] (or pH) * Check pCO2 and [HCO3-] * Check for compensation

Question 28

What are the two main types of acid-base disorders?

Answer 28

Metabolic and Respiratory ## Footnote Acid-base disorders can be classified based on their origin: metabolic or respiratory.

Question 29

What physiological response corrects altered pH in acid-base disorders?

Answer 29

Compensation ## Footnote Compensation is the body's response to restore normal pH levels.

Question 30

What are the three mechanisms the body uses for compensation?

Answer 30

Buffers, Respiratory system, Metabolic system ## Footnote These mechanisms work together to help maintain acid-base balance.

Question 31

What does a low pH indicate in relation to acid-base disorders?

Answer 31

Acidosis ## Footnote A low pH signifies an excess of hydrogen ions, leading to acidosis.

Question 32

What changes occur in metabolic acidosis?

Answer 32

Low pH, Low HCO3- ## Footnote Metabolic acidosis is characterized by decreased bicarbonate levels.

Question 33

In respiratory acidosis, what happens to pCO2 levels?

Answer 33

Up ## Footnote Respiratory acidosis is marked by an increase in carbon dioxide levels.

Question 34

What is the effect of metabolic alkalosis on H+ concentration?

Answer 34

Low ## Footnote Metabolic alkalosis results in a decreased concentration of hydrogen ions.

Question 35

Fill in the blank: In respiratory alkalosis, pCO2 levels are _______.

Answer 35

Down ## Footnote In respiratory alkalosis, the carbon dioxide levels decrease.

Question 36

What is the relationship between [H+] and pH?

Answer 36

Inverse ## Footnote An increase in hydrogen ion concentration ([H+]) results in a lower pH.

Question 37

What laboratory measurements are crucial for investigating acid-base disorders?

Answer 37

[H+], PCO2, HCO3- ## Footnote These measurements help determine the nature of the acid-base imbalance.