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FOM Quiz 5 > 10:15 Acid:Base > Flashcards

10:15 Acid:Base Flashcards

1
Q

why is pH regulation important in the body?

A

conformational state of proteins; rate of enzyme reactions; cell proliferation; ligan-receptor interations; muscle contraction; transmembrane flux of ions; Ca2+ binding to molecules, including bone.

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2
Q

what is the basic action of changing the pH of a solution?

A

it makes the binding and release of protons happen on molecules

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3
Q

where do the acids and bases come from?!

A

protons are produced metabolically; and there are weak acid groups (R-COOH carboxylate) weak bases (R-NH+3 amine) on many molecules.

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4
Q

if you chnage the pH of the muscle (make it greater) what happens to the contraction of the heart?

A

It will increase in strenght!

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5
Q

why does CO2 matter so much in pH control?

A

it easily ineracts with water and this makes carboxcylic acid that can be carbonate and a H+

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6
Q

what makes CO2 into an acid much faster than the body would do natrually?

A

Carbonic Anhydrase

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7
Q

How do we get rid of volatile acids?

A

excreted via lungs

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8
Q

how do we get rid of the nonvolatile acids?

A

excreted via kidneys

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9
Q

how is adic exreted in the urine?

A

as ammonium (NH+4 and H2PO4

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10
Q

what are the key players in acid base control?

A

lungs, kidneys, and buffers.

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11
Q

how does lungs affect pH

A

increase resperation then excrete more CO2 and increase the pH

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12
Q

how do kidneys affect the pH

A

vary amount of H+ excreted and HCO3- reabsorbed. changes the blood pH slowly (hrs, days)

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13
Q

how does the Co2 concentration change as you move thorugh the blood.

A

after the lungs it is about 40 mmHg, then after it goes thorugh the capillaries, it is at about 46 mmHg, it stays like that until the lungs and then it gets expelled and drop back to 40mmHg

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14
Q

how does the pH change in circulation?

A

7.4 after the lungs, goes to 7.35 as the CO2 goes up after the capilaries, then back to 7.4 after the lungs.

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15
Q

the eqution for the amount of CO2 in th blood

A

PaCO2 proportional to rate of VCO2/ rate of Va

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16
Q

what if you hold your breath what happens to CO2 and pH

A

the CO2 goes up and pH goes down!

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17
Q

what if you hyperventilate: what happens to pH and CO2

A

then CO2 goes down and pH goes up. and HCO3- goes down

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18
Q

what is the main stimulus to make you take a breath when you try to stop breathing?

A

the chemo-receptors that sense a large amount of CO2

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19
Q

what is pH?

A

measure of free proton concentration…

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20
Q

pH = ?

A

-log[H+] ten fold increase with one value increase in pH.

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21
Q

what is pHo?

A

the normal arterial (extracellular) pH 7.35-7.45

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22
Q

what is acidosis

A

process that causes acidemia (low blood pH)

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23
Q

what is alkalosis

A

process that causes high blood pH (alkalemia)

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24
Q

what is acidemia

A

blood pH below 7.35

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25
Q

what is alkalemia

A

blood pH above 7.45

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26
Q

what are the extreme limits of pH?

A

6.8-7.8

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27
Q

affects of severe acidemia

A

decreased cardiac contraction, coma etc.

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28
Q

affects of sever alkelemia

A

decreased cerebral blood flow, confusion, etc.

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29
Q

pHi

A

cytoplasmic pH 7.00-7.2

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30
Q

what pH would lead to myocardial ischemia?

A

pHo-pHi ~ 6.5 to 6.0

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31
Q

what is the normal range of PCO2

A

35-45

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32
Q

what is the normal range of [HCO-3]

A

22-26

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33
Q

what do we measure in the clinic?

A

take an arterial blood sample and put it in a blood gas machine

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34
Q

how does every cell regulate acid?

A

by having acid importers and exporters

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35
Q

how do we regulate pH Protons out of a cell? (if low pHi)

A

use secondary gradient transporters: NHE (Na+ in and H+ out) NBC (Na + in and 2HCO3-); MCT(Lactate- out and H+ out) then CO2 come in on its own!;

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36
Q

how do we regulate pH protons into a cell? (if high pHi)

A

CBD (Cl- in and HCO-3 out); CHE(Cl- in and OH- out) CO2 in and out on its own!

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37
Q

what is the first response to a change in pH?

A

the buffers will attenuate the pH change but will not bring back a change that happens!

38
Q

what are some important weak acids/bases?

A

ammonium; carbonic acid; dihydrogen phosphate; lactic acid.

39
Q

what are the first line of defense against pH change buffers that are not simple weak acid/base

A

proteins, peptides, etc. such as hemoglobin; phosphates; and esp. HCO3- / CO2

40
Q

Low pKs

A

strong acid

41
Q

High pKs

A

weak acids

42
Q

what is the pK of an acid?

A

the -log of the dissociation constant which is a measure of the amount of the acid that dissociates.

43
Q

what pH / pK are buffers most effective?

A

when the pH = pK then the buffer is most effective!

44
Q

what is the Henderson-Hasselbalch equation?

A

pH=pKa + log conjugate base / acid

45
Q

what is the importnat physiological form of h-h equation?

A

pH=6.1+log [HCO-3]/0.03 [PCO2]

46
Q

what does blood pH depend on?

A

the ration of conjugate base to acid, that is the ratio of kidney and lung function

47
Q

Conceptual form of H-H equation

A

pH of blood plasm= constant + Kidneys / Lungs

48
Q

what happens with hypoventilation (example of respiratory acidosis)?

A

increase PaCO2, decrease in pH

49
Q

how would the renal compensate for hypoventilation?

A

secretion of H+ and increase blood HCO3- then pH increases towards normal slowly

50
Q

how would the renal compensate for hyperventilation?

A

decrease kidney secretion of H+ and Decrease HCO3- reabsorption.

51
Q

how do you compensate for hyperventilation?

A

Decrease in blood HCO3- in the renal system.

52
Q

What is metabolic acidosis?

A

decreased blood HCO-3

53
Q

what is the pulmonary response to metabolic acidosis

A

Pulmonary compensation: chemoreceptors sense this and increase alveolar ventilation, decreases PaCO2 and brings pH back towards normal.

54
Q

Metabolic alkalosis

A

increased blood HCO3-

55
Q

pulmonary response to metabolic alkalosis

A

decreased alveolar ventilation, increases PaCO2, pH back down

56
Q

a single acid base disturbance with its accompanying compensatory response

A

simple acid base disorder

57
Q

how will mechanisms respond for a simple acidid base disorder/

A

it may not return pH completely to normal and never overshoot.

58
Q

how will a change in pCO2 change the [HCO3-]? in the acute phase of hypo-vent?

A

1 mmHG increase in PCO2 will give 0.1mM increase in [HCO3-]

59
Q

how will a change in pCO2 change the [HCO3-]? in the chronic phase of hypo-vent

A

1 mmHG increase in PCO2 will give 0.4mM increase in [HCO3-]

60
Q

how will a change in pCO2 change the [HCO3-]? in the acute phase of hyper-vent?

A

1 mmHG decrease in PCO2 will give 0.2mM decrease in [HCO3-]

61
Q

how will a change in pCO2 change the [HCO3-]? in the chronic phase of hyper-vent

A

1 mmHG decrease in PCO2 will give 0.4mM decrease in [HCO3-]

62
Q

what are some key causes of metabolic acidosis

A

ketogenesis (diabetes); slicylic acid ingestion; lactic acid; renal failure; diarrhea

63
Q

how will a down change in [HCO3-] affect pCO2?

A

1mM decrease in [HCO3-] is a 1.3 mmHg decrease in PCO2.

64
Q

causes of metaboic alkalosis

A

vomiting. impaired ability of kidney to excrete bicarb

65
Q

how will up change in [HCO3-] affect pCO2?

A

1mM increase in [HCO3-] is a 0.7 mmHg increase in PCO2.

66
Q

how to determine if we have metabolic/respiratory acidemia/alkalemia?

A

look if pH is acid or alkaline. Look to see if the PCO2 or the HCO-3 change is in line with the pH deviation. then look for compensation!

67
Q

what are the three main ways that the renal system helps with pH?

A

glomerular filtration, tubular reabsorption of bicarbonate; tubular secretion hydrogen ion

68
Q

if the pH is low what happens in the PCT

A

generate and reabsorbs HCO-3

69
Q

if the serum pH is high,

A

PCT HCO-3 reabsorption slows and there is increased H+ secretion

70
Q

what isthe timeline for pH control in teh kidneys

A

the process can take hours to days.

71
Q

where does HCO-3 reabsorption happen?

A

80-90% in the PCT; CD about 10-15%

72
Q

how will HCO3- reabsorption affect pH

A

increase serum pH

73
Q

What is the Carbonic acid cycle that leads to HCO3- reabsorption in the PCT?

A

low pH: CO2 into the PCT cell: generate H2CO3 and then release a HCO3 to the basal side and H+ that is secreted to apical side and combines with more HCO3- in the filtrate. Brush border carbonic anhydrase forms more CO2 +H2O and imports it and repeats. (in the end it looks like we take H2CO3 from apical and push it out the basal side of the cell)

74
Q

How does the collecting duct help with acid control

A

intercalated cells in the collecting duct secrete H+ (from Alpha-intercalated cells).

75
Q

how does aldosterone affect acid control

A

plays a small part on intercalated cells. up aldosterone, and up H+ secretion; down urine pH, up serum pH.

76
Q

has principle and intercalated cells

A

the collecting duct (principle does water/ions, and the intercalacted does acid/base)

77
Q

How does excreting H+ lead to lower pH in the serum

A

each H+ excreted gives one HCO3- that is reabsorbed and can buffer more H+ in the serum.

78
Q

Describe the excretion of acid in alpha-intercalated cells

A

CO2 used to make proton and HCO3-. The HCO3- secreted to plasma. H+ extreted to filtrate. H+ titrates and acid and excreted.

79
Q

How else can we excrete a H+ into the filtrate, besides the H+ ATPase pump or the K/H atpase?

A

as amonium

80
Q

what types of pumps regulate the acid excretion in the tubules?

A

mostly ATPases for H+ and H+/K+. and some anti-transporter

81
Q

where is the regulatino for acid/base int eh kidney?

A

it is in the collecting duct, not in the proximal duct

82
Q

what happens in renal failure to acid/base?

A

nitrogen and acid excretion down: organic acids and nitrogenous waste occumulate in blood.

83
Q

what is and anion gap?

A

unmeasured anions in the blood.

84
Q

how to calc. anion gap?

A

Na+ - (Cl- + HCO3-)

85
Q

what is a normal anion gap?

A

8-12ish

86
Q

what causes an anion gap

A

the accumulation of organic acids in diseases like “MUDPILES”

87
Q

when to check for anion gap?

A

if there is a metabolic acidosis then check for anion gap.

88
Q

what are the MUDPILES

A

methonal; uremia/organic acids; diabetic/Alcoholic/starvation ketoacidosis; paraldehyde; iron,isoniazid; lactic acid; ethylene glycol; salicylates.

89
Q

what could cause non-gap metabolic acidosis

A

diarrhea. renal disorders; hyperchloremia (high Cl-); lots of IV saline.

90
Q

what exchanger helps keep the anion gap normal

A

chloride/bicarbonate exchanger in erythrocytes and PCT.

FOM Quiz 5 (6 decks)

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