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942 > Test 5 (acid base) > Flashcards

Test 5 (acid base) Flashcards

1
Q

(weak/strong acid or base)

  • Reacts rapidly & strongly with Hydrogen to quickly remove H+ from solution
  • Ex: OH- because it reacts strongly with hydrogen to form water
A
  • Strong base
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2
Q

The degree of disassociation of substances in water determines whether they are a __ __/__

A

The degree of disassociation of substances in water determines whether they are strong acid/base.

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3
Q

a compound that produces hydroxyl ions in water

A

base

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4
Q
  • An __ is a compound that when it reacts with water gives off H+ ion.
  • A ___is a compound that produces hydroxyl ion in water.
A
  • An acid is a compound that when it reacts with water gives off H+ ion.
  • A base is a compound that produces hydroxyl ion in water.
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5
Q
A
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6
Q

example of base that combines with H2O

A
  • Bicarbonate (HCO3) because it can combine with water to form carbonic acid (H2CO3).
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7
Q
  • one of the most important body bases.
A
  • Protein that are in hemoglobin in RBCs and some of the proteins found in other cells are one of the most important body bases.
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8
Q
  • Molecule formed by combination of 1 or more alkaline metals + OH- .
  • Ex sodium(Na), Potassium (K), lithium (Li) etc. which can react with a high basic ion such as hydroxyl.
A

Alkali

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9
Q
  • Less likely to dissociate their ions; hydrogen is not released as quickly
  • EX: H2CO3
A
  • Weak acid
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10
Q
  • Binds with H+ more weakly
  • Ex: HCO3-
A
  • Weak base:
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11
Q
  • Rapidly dissociates & releases large amounts H+ in the solution
  • Ex: HCL
A
  • Strong acid
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12
Q

formula for a normal pH

A
  • pH = log 1/[H+] = −log[H+]
  • Normal [H+] is 40 nEq/L (0.00000004Eq/L) or
  • pH = − log[0.00000004]
  • pH = 7.4
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13
Q
  • what is the range for urine pH
  • depends on what?
A
  • Urine pH range: 4.5-8.0
    • Depends on acid-base status of ECF
    • Kidneys play a major role in regulating the status.
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14
Q
  • Gastric pH
  • secreted form what cells
  • pH
  • H+ conc compared to blood
A
  • Gastric pH
    • Example of an extremely acidic bodily fluid is hydrochloric acid (HCl) that is secreted from parietal cell of the stomach mucosa pH is 0.8 because of H+ concentration is 4 million times more than that found in the blood.
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15
Q

3 Primary Systems Regulate H+ concentration

A
  • 3 Primary Systems Regulate H+ concentration
    • 1) Chemical acid-base buffer system
      • Rapid (immediate)
      • Buffer systems do not remove or add H+ but rather bind H+
    • 2) Respiratory system
      • Rapid (3-12 minutes)
      • Removes CO2 in form of carbonic acid
    • 3) Kidneys
      • Slow (1-2 days)
      • Eliminates excess acid or base
      • Most powerful
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16
Q

where is carbonic acid abundant

A
  • Enzyme is especially abundant in the walls of the alveoli where CO2 is released
  • Also present in large amount in the epithelium cells of renal tubules where CO2 reacts with water to form carbonic acid
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17
Q

•Bicarbonate Buffer System

2 parts

A

•Bicarbonate Buffer System

  • Weak acid
  • Bicarbonate salt
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18
Q
  • For any acid, concentration of acid relative to its dissociated ions is defined by ____ ____
A
  • For any acid, concentration of acid relative to its dissociated ions is defined by the dissociation constant K’
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19
Q
  • CO2 dissolved in blood directly proportional to what?
A
  • CO2 dissolved in blood directly proportional to amount of undissociated H2CO3
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20
Q
A
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21
Q

what is the henderson-hasselbalch equation/formula?

A

•Bicarbonate buffer system

  • pH = pK + log [HCO3-/(0.03 x PCO2)]
  • pH = 6.1 + log [HCO3-/(0.03 x PCO2)]
  • pK is 6.1
  • 0.03 is solubility coefficient for CO2
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22
Q

Bicarbonate buffer system is the most important _____ intra/extra-cell buffer

A

Bicarbonate buffer system is the most important extracellular buffer

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23
Q

there’s ___ x as much of the bicarbonate buffer system in the form of bicarbonate (HCO3-) as there is in the form of CO2

A

there’s 20 x as much of the bicarbonate buffer system in the form of bicarbonate (HCO3-) as there is in the form of CO2

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24
Q

why is bicarb system, although most important, not expected to be powerful (2):

A
  • 20 x as much HCO3 > CO2
    • operates on the portion of the buffering curve where the slope is very low, and so that suggests that buffering power would be poor.
  • Concentrations of CO2 & HCO3- not great
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25
Q

Speed/rate of buffering by plasma bicarbonate

A
  • Buffering by plasma bicarbonate
    • Almost immediate
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26
Q

below pH of 7.4, the hydrogen ion concentration increases ___ nano-equivalents per liter (nEq/L) for each ___ decrease in pH

A
  • below pH of 7.4,
  • the hydrogen ion concentration increases 1.25 nano-equivalents per liter (nEq/L) for each 0.01 decrease in pH
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27
Q
  • above a pH 7.4, the hydrogen ion concentration will decrease at a rate of 0.8 nEq/L for each 0.01 increase in pH
A
  • above a pH 7.4
  • the hydrogen ion concentration will
  • decrease at a rate of 0.8 nEq/L for each 0.01 increase in pH
28
Q
  • When disturbances of acid-base result from primary change in extracellular fluid HCO3- concentration
A
  • When disturbances of acid-base result from primary change in extracellular fluid HCO3- concentration is, that is referred to as a metabolic acid-base disorder
29
Q
  • Respiratory acidosis – caused in ___
    • Acidosis caused by what primarily?
A
  • Respiratory acidosis – caused in ↑ PCO2
    • Acidosis caused by a primary increase in the partial pressure of carbon dioxide is respiratory acidosis
30
Q

Respiratory alkalosis – caused by

A
  • Respiratory alkalosis – caused by ↓ PCO2
    • Alkalosis that is due to a decrease in the partial pressure of carbon dioxide is respiratory alkalosis
31
Q

most important noncarbonic buffer in ECF

A

Hgb

32
Q
  • In RBC, HGB important buffer, it keeps the pH and Pk at what levels?
A
  • In RBC, HGB important buffer
  • it keeps the pH 5.7-7.7
    • (pKa 6.8)
33
Q
  • Approximately ____% of the total buffering of body fluids is intra/extra cell and most of this is due to ___ ____
A
  • Approximately 60-70% of the total buffering of body fluids is inside cells and most of this is due to intracellular proteins
34
Q
  • compare Hg buffer system to bicarbonate buffering system
A
  • In contrast to the bicarbonate buffer, hemoglobin is capable of buffering both carbonic (CO2) & noncarbonic (nonvolatile) acids
35
Q
  • ____ mol/L dissolved CO2 in ECF
  • corresponds to PCO2 of ___ mmHg
A
  • ~ 1.2 mol/L dissolved CO2 in ECF
  • corresponds to PCO2 of 40 mmHg
36
Q
  • If the metabolic process is constant (metabolism not high or low), the only thing that will affect the level of the partial pressure of CO2 in ECF is the rate of ____ _____
A
  • If the metabolic process is constant, the only thing that will affect the level of the partial pressure of CO2 in ECF is the rate of alveolar ventilation.
37
Q
  • how does H+ concentration affect the rate of alveolar ventilation
  • and by what feedback mechanism
A
  • H+ concentration affects rate of alveolar ventilation
    • when the pH decreases, alveolar ventilation will increase to eliminate more carbon dioxide
    • If pH rises, alveolar ventilation will decrease in order to reduce the amount of carbon dioxide eliminated.
    • This process is a NEGATIVE feedback mechanism
38
Q
  • If the pH of ECF is 7.4 with normal alveolar ventilation
    • ↑ alveolar ventilation to 2x normal ↑ pH ~ ___- to about __
    • ↓ in alveolar ventilation to ¼ normal ↓ pH by __- to __
A
  • If the pH of ECF is 7.4 with normal alveolar ventilation
    • ↑ VA to 2x normal ↑ pH ~ 0.23- to about 7.63
    • ↓ VA to ¼ normal ↓ pH by 0.45- to 6.95
39
Q
  • Normally the respiratory mechanism for controlling H+ ion concentration is ≈ _____% effective which is a feedback mechanism of 1 to 3
A
  • Normally the respiratory mechanism for controlling H+ ion concentration is ≈ 50-75% effective which is a feedback mechanism of 1 to 3
40
Q
  • The respiratory regulation of the acid-base balance is a _____ type of buffer system
    • It acts rapidly to control hydrogen ion concentration until the ___ can eliminate the imbalance
    • Buffering power is ___ x as much acid or base as that of all the other chemical buffers in the body
A
  • The respiratory regulation of the acid-base balance is a physiological type of buffer system
    • It acts rapidly to control hydrogen ion concentration until the kidneys can eliminate the imbalance
    • Buffering power is 1-2 x as much acid or base as that of all the other chemical buffers in the body
41
Q
  • Alveolar ventilation mediated by ____ in brainstem
  • Respond to changes in CSF p___
  • MV ↑___L/min for every acute ___ mmHg ↑ PaCO2
  • For the most part, lungs eliminate approx. _____mEqs of CO2 per day as a byproduct of ____ and ___metabolism
A
  • Alveolar ventilation mediated by chemoreceptors in brainstem
  • Respond to changes in CSF pH
  • MV ↑ 1-4L/min for every acute 1 mmHg ↑ PaCO2
  • For the most part, lungs eliminate approx. 15 mEqs of CO2 per day as a byproduct of carbohydrate and fat metabolism
42
Q
  • Decreases in arterial blood pH stimulate the medullary respiratory centers
A
  • Decreases in arterial blood pH stimulate the medullary respiratory centers
43
Q
  • PaCO2 ↓___ mmHg from 40 mmHg for every___mEq/L ↓ plasma HCO3-
A
  • PaCO2 ↓ 1-1.5 mmHg from 40 mmHg for every 1 mEq/L ↓ plasma HCO3-
44
Q
  • PaCO2 normally does not ↑ above ___ mmHg in compensation in response to metabolic alkalosis
    • PaCO2 Can be expected to ↑___ mmHg for each 1 mEq/L ↑ HCO3-
A
  • PaCO2 normally does not ↑ above 55 mmHg in compensation in response to metabolic alkalosis
    • PaCO2 Can be expected to ↑ 0.25-1 mmHg for each 1 mEq/L ↑ HCO3-
45
Q

Renal Control

  • Removes base from the blood by
A

Renal Control

  • Kidneys control the acid-base balance by excreting either acidic or basic urine
  • Mechanism:
  • Large amounts of HCO3- continuously filtered into tubules
  • Removes base from the blood
46
Q

Renal Control

  • Removes acid from the blood by
A

Renal Control

  • Large amounts of H+ secreted into tubular lumen by tubular epithelial cells
  • Removes acid from the blood
47
Q

Renal Control

  • More H+ lost than HCO3- → net loss of ___from extracellular fluid
  • More HCO3- lost than H+ → net loss of ___
A

Renal Control

  • More H+ lost than HCO3- → net loss of acid from extracellular fluid
  • More HCO3- lost than H+ → net loss of base
48
Q

Renal control

  • Body produces ~___ mEq of nonvolatile acids each day (cannot be excreted by lungs)
A
  • Body produces ~ 80 mEq of nonvolatile acids each day (cannot be excreted by lungs)
49
Q
  • Each day kidneys filter ~ ___ mEq HCO3-, most of which is reabsorbed by the ____
  • Reabsorption of HCO3- & secretion of H+ are accomplished by process of____________________
A
  • Each day kidneys filter ~ 4320 mEq HCO3-, most of which is reabsorbed by the tubules
  • Reabsorption of HCO3- & secretion of H+ are accomplished by process of H+ secretion by the tubules
50
Q
  • This is the total H+ ions secreted into the tubules each day
A
  • 4400 H+ ions secreted into the tubules each day
51
Q
  • The kidneys regulate ECF H+ concentration through 3 mechanisms:
A
  • The kidneys regulate ECF H+ concentration through 3 mechanisms:
  1. Secretion of H+
  2. Reabsorption of filtered HCO3-
  3. Production of new HCO3-
52
Q
  • H+ secretion & HCO3- reabsorption occur in renal tubules except the _____ and _______.
A
  • H+ secretion & HCO3 - reabsorption occur in tubules except the descending and ascending thin limbs of the loop of Henle
53
Q
  • An acute change of PaCO2 by 10 mmHg is associated with change in pH of ___ units
A
  • An acute change of PaCO2 by 10 mmHg is associated with change in pH of 0.08 units
54
Q
  • Metabolic acidosis should be referred to as ____ _____
  • Causes include:
A
  • Metabolic acidosis should be referred to as nonrespiratory acidosis
  • Does not always involve change in metabolism
  • Causes include:
    • ingestion of poison
    • infusion or production of a fixed acid such as lactic acidosis
    • decreased excretion of acid by the kidneys
55
Q

according to notes..

  • An increase of PaCO2 with normal bicarb level is
A

according to notes..

  • An increase of PaCO2 with normal bicarb level is uncompensated respiratory acidosis
56
Q

according to notes..

  • Decrease in bicarb level when PaCO2 remains ~ 40 mmHg is uncompensated metabolic acidosis
A
57
Q
  • Combination of respiratory & metabolic acidosis is __ __
A
  • Combination of respiratory & metabolic acidosis is mixed acidosis
  • Dramatic change in pH with this situation
58
Q
  • Base change of 10 mEq/L is associated with pH change of ____ unit
    • (in absence of change in PaCO2)
A
  • Base change of 10 mEq/L is associated with pH change of 0.15 unit
    • (in absence of change in PaCO2)
59
Q

can tubules reabsorb extra HCO3 in alkalosis

A

negative

urine will be basic

60
Q
  • Removing HCO3- by renal excretion has the same effect as what (relating to H)
A
  • Removing HCO3- by renal excretion has the same effect as adding H+ to ECF and helps return the H+ concentration and pH back toward normal
61
Q
  • The kidneys can compensate for respiratory acidosis and metabolic acidosis of non-renal origin by: (2)
A
  • excreting fixed acid
  • retaining HCO3- (Bicarb)
62
Q
  • The kidneys can compensated for respiratory alkalosis and metabolic alkalosis of non-renal origin by:
A
  • Decreasing H+ ion excretion
  • decreasing the retention of Bicarbonate
63
Q
  • Metabolic acidosis:
    • ​causes
A
  • Metabolic acidosis:
    • Kidney failure
    • diarrhea
    • vomiting (intestinal contents)
    • diabetes mellitus
    • ingestion of certain poisons
64
Q

causes of metabolic alkalosis

A
  • Diuretics (except carbonic anhydrase inhibitors)
  • excess aldosterone
  • ingestion of alkaline drugs (antacids)
  • vomiting (gastric contents)
65
Q

Bicarb dose formula

and calculate for 70 kg, base deficit -10mEq/L

A

Bicarb dose:

  • Base deficit x 30% x body weight in Kg
    • 10 x 0.30 x 70 = 210 (absolute value)

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