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PHYSIOLOGY II > Lecture 9: Renal & Respiratory Compensation > Flashcards

Lecture 9: Renal & Respiratory Compensation Flashcards

1
Q

how does metabolic alkalosis affect pH and [HCO3-]

A

increases pH
increases [HCO3-]

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2
Q

how does metabolic acidosis affect pH and [HCO3-]

A

decreases pH
decreases [HCO3-]

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3
Q

what is the effect of compensation in response to metabolic alkalosis

A

increases PCO2

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4
Q

what is the effect of compensation in response to metabolic acidosis

A

decreases PCO2

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5
Q

what is the effect of respiratory alkalosis on pH and PCO2

A

pH increases
PCO2 decreases

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6
Q

what is the effect of respiratory acidosis on pH and PCO2

A

pH decreases
PCO2 increases

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7
Q

what is the effect of compensation in response to respiratory alkalosis

A

decreases [HCO3-]

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8
Q

what is the effect of compensation in response to respiratory acidosis

A

increases [HCO3-]

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9
Q

what 3 mechanisms help keep plasma pH within a narrow range

A
  • buffers
  • respiratory response
  • renal response
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10
Q

when blood gases and or pH change, _________ trigger changes in ventilation (tidal volume and breathing rate)

A

chemoreceptors

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11
Q

what do brainstem receptors monitor

A

CO2 and pH

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12
Q

what do peripheral receptors monitor

A

O2, CO2, pH

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13
Q

Carotid and aortic bodies monitor ??

A

O2, CO2, pH
b/c they are peripheral chemoreceptors

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14
Q

how do glomus cells respond when O2 tension or pH decreases, or when CO2 increases

A

depolarize

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15
Q

a decrease in PaO2 below ____-_____mmHg causes carotid and aortic bodies to stimulate respiration

A

60-70

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16
Q

central chemoreceptors monitor _____

A

CO2 (and pH)

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17
Q

how does CO2 effect breathing

A

CO2 crosses BBB
increases H+ ion concentration in brain interstitial fluid, activating central chemoreceptors

18
Q

what happens to breathing rate if pH decreases in CSF

A

breathing increases

19
Q

what happens to breathing rate if pH increases in CSF

A

breathing rate decreases

20
Q

how doe the kidneys excrete an acid load?

A
  1. bicarbonate reabsorption
  2. titratable acidity
  3. ammonia genesis and NH4+ excretion
  4. bicarbonate secretion if available in excess
21
Q

where in the tubular system is H+ secreted

A

proximal tubule

22
Q

is bicarbonate freely filtered?

A

yes

23
Q

bicarbonate uptake is dependent on the activity of _______ in the cell ?

A

carbonic anhydrase

24
Q

within the cell, ______ facilitates the generation of H+ and HCO3-

A

CA-II

25
Q

what is the most important transporter in the PT

A

Na/H+

26
Q

what facilitates the production of water and CO2 from luminal carbonic acid

A

membrane bound carbonic anhydrase

27
Q

how does HCO3- exit the cell

A

by crossing the basolateral membrane

28
Q

what are the steps of bicarbonate reabsorption

A
  1. w/in the cell, CA-II facilitates the generation of H+ and HCO3-
  2. H+ is secreted into tubular fluid
  3. membrane-bound CA facilitates production of water and CO2 from luminal carbonic acid
  4. membrane permeable for CO2
    5.HCO3- exits cell across basolateral membrane
29
Q

what are the 3 transporters in the apical membrane of epithelial cells that secrete protons

A
  • Na+/H+ exchanger
  • H+ATPase
  • K+/H+ ATPase
30
Q

where in the tubular system is HCO3- reabsorbed

A

Collecting Duct

31
Q

what is titratable acidity

A
  1. kidney excretes H+ w/ urinary buffers like phosphate and urate
    - secreted protons bound to buffer ions are retained in tubule fluid then excreted
  2. a “new HCO3-“ is generated
32
Q

how does ammoniagenesis and NH4+ excretion occur

A
  1. kidney metabolizes glutamine
  2. NH4+ is excreted or returned to blood
  3. HCO3- is returned to the blood as “new HCO3-“
33
Q

3 steps of ammonium excretion

A
  1. PT: ammoniagenesis enables bicarbonate production and absorption; NH4+ is transported into tubule fluid
  2. TAL: NH4+ is reabsorbed by Na/K/2Cl co-transporter (medullary recycling)
  3. CD: ammonia trapping
    - High NH3/NH4+ concentrations in medullary interstitium favors excretion
34
Q

renal removal of NH4+ is enhanced by ________ in dogs, chickens, rats and mice but not in cats or rabbits

A

acidosis

35
Q

how do the kidneys excrete a load of [H+] or replace a bicarbonate deficit?

A
  • reabsorption of all filtered bicarbonate
  • additional H+ secreted via H+ATPases attached to bases (either titratable acids or via glutamine metabolism)
36
Q

in the cortical CD, what type of cells contain H+ATPase in the basolateral plasma membrane

A

type B intercalated cells

37
Q

type B intercalated cells are rich in ______ ?

A

cytoplasmic carbonic anhydrase

38
Q

what exchanger is in the apical plasma membrane of the CD and mediates HCO3- secretion

A

Cl-/HCO3-, pendrin

39
Q

what is the pendrin transporter (Cl/HCO3-) dependent on

A

sufficient Cl levels

  • low Cl levels can cause impairment of bicarbonate secretion by type B intercalated cells —–> metabolic alkalosis
40
Q

Renal response to Alkalosis results in a reduction of ______ excretion and an increase in _______ secretion

A

reduced acid (NH4+) excretion
increased bicarbonate secretion

41
Q

renal response to Acidosis results in the reduction/elimination of all _______ from urine and promotes ______ secretion

A

elimination of HCO3- from urine
acid secretion

PHYSIOLOGY II (17 decks)

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