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Pathophysiology > 25 Acid-Base Homeostasis and Imbalance > Flashcards

25 Acid-Base Homeostasis and Imbalance Flashcards

1
Q

death range of pH

A

too acidic<6.9-7.8

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2
Q

maintenance of acid-base balance reflects homeostatic functions of ___

A

normal cellular metabolism

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3
Q

if pH is too acidic, proteins will ____

A

get denatured

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4
Q

normal pH

A

7.35-7.45

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5
Q

normal PaCO2

A

36-44 mmHg

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6
Q

normal HCO3-

A

22-26 mEq/L

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7
Q

useful indicators of acid-base status of ECF

A

arterial blood gas [ABG]

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8
Q

PaCO3 indicates ___

A

how effectively the respiratory sytm is excreting carbonic acid

lung/respiratory function

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9
Q

HCO3- indicates ___

A

effectiveness of renal regulation of metabolic acids

  • excess or deficit of metabolic acids
  • renal/metbolic function
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10
Q

3 major systems to regulate acid-base

A

1 buffer
2 respiratory sytm
3 renal sytm

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11
Q

compensatory mechanisms to regulate acid-base

A

respiratory + renal system

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12
Q

first line of defense against pH changes in all body fluids

A

Bicarbonate Buffer system

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13
Q

chemicals that help control pH of body fluids

A

1 Bicarbonate ions [HCO3-]

2 Carbonic acid [H2CO3]

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14
Q

Bicarbonate Ions

A

HCO3-
basic
-takes up H when fluid is too acidic

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15
Q

Carbonic Acid

A

H2CO3
weak acid
-release H ions when fluid is too alkaline

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16
Q

types of buffers

A

1 bicarbonate buffers
2 phosphate buffers
3 hemoglobin buffers
4 protein buffers

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17
Q

bicarbonate buffer system RXN

A

H2O + CO2 <> H2CO3 <> H+ + HCO3-

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18
Q

bicarbonate buffer system

A

primary defense against acid-base disorders

-most important buffer in ECF

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19
Q

when body fluid is acidic, H+ is high >

A

H+ + HCO3- > H2CO3 > H2O + CO2 > exhale CO2

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20
Q

when body fluid is alkaline, H+ is low >

A

H2CO3 > H+ HCO3-

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21
Q

NonVolatile Acids

A

lactic acid, acetoacetic acid, keto acid

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22
Q

the lungs can excrete ____ acid only

A

the lungs can excrete CARBONIC ACID only;

the CANNOT excrete nonvolatile acids

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23
Q

Volatile Acid

A

carbonic acid

24
Q

Respiratory Acidosis

A

INCR PaCO2; DECR pH

-condition that cause excess of carbonic acid

25
Q

Respiratory Acidosis

respiratory response

A

hyperventilation CORRECTS imbalance

-excretes CO2

26
Q

Respiratory Alkalosis

A

DECR PaCO2; INCR pH

27
Q

Respiratory Alkalosis

respiratory response

A

hypoventilation CORRECTS imbalance

bc decr O2, incr retention of CO2

28
Q

Metabolic Acidosis

A

DECR pH fr excess metabolic acids

29
Q

Metabolic Acidosis

respiratory response

A

hyperventilation COMPENSATES imbalance

30
Q

Metabolic Alkalosis

A

INCR pH fr deficit of metabolic acids

31
Q

Metabolic Alkalosis

respiratory response

A

hypoventilation COMPENSATES for imbalance

32
Q

respiratory response to metabolic acidosis/alkalosis can only COMPENSATE for pH imbalance because…

A

respiratory can only excrete carbonic acid, NOT metabolic acids (nonvolatile acids)

33
Q

carbonic acid is solely excreted by

34
Q

kidneys can excrete ____ acid from the body except ____ acid

A

kidneys can excrete ANY acid except CARBONIC acid

35
Q

which organ excretes metabolic acid?

36
Q

Kidneys can COMPENSATE for respiratory pH imbalance aka carbonic acid excess/deficit. However, the kidneys require ____

A

several days to be fully operative.

37
Q

INCREASED HCO3-

A

indicates deficit of metabolic acids

38
Q

INCREASED HCO3-

A

indicates deficit of metabolic acids

39
Q

how do kidneys compensate for excess/deficit of carbonic acid [H2CO3-]?

A

EXCSS: excrete metab acid + H+

DFCT: excrete HCO3- (bicarbonate)
decrease excretion of metab acid + H+

40
Q

4 primary acid-base disorders

A

1 Respiratory Acidosis
2 Respiratory Alkalosis
3 Metabolic Acidosis
4 Metabolic Alkalosis

41
Q

Respiratory Acidosis

cause

A

caused by impaired removal of carbonic acid by lungs

  • impaired gas exchange
  • inadequate neuromuscular function
  • impairment of respiratory control in brainstem
42
Q

examples of impaired gas exchange that can cause resp.acid.

A 
1 COPD
2 Pneumonia
3 Severe Asthma
4 Pulmonary Edema
5 ARDS
43
Q

examples of inadequate neuromuscular function that can cause resp.acid.

A 
1 guillain-carre syndrom
2 chest injury/surgery (pain limits breathing)
3 hypokalemic resp muscle weakness
4 severe kyphoscoliosis
5 resp muscle fatigue
44
Q

examples of impaired resp control (brainstem) that can cause resp.acidosis

A

respiratory-depressant drugs like opioids or barbiturates

45
Q

Respiratoy Alkalosis

cause

A

carbonic acid deficit is usually caused by hyperventilation

bc gets rids of CO2

46
Q

what causes hyperventilation which can cause resp.alka.

A 
1 hypoxemia
2 acute pain
3 anxiety, psych stress
4 prolonged sobbing
5 alcohol withdrawal
6 stim of brainstem
47
Q

relative excess of any acid except carbonic acid is ___

A

Metabolic Acidosis

48
Q

normal ratio of HCO3-:H2CO3

49
Q

how is normal ratio of bicarbonate (hco3-) decreased to carbonic acid (h2co3)

A

bicarbonate ions are used up in buffering excess acid

50
Q

Starvation Ketosis

A

bicarbonates get used up to buffer excess acid; causes decrease in normal bicarb to carb.acid ratio

51
Q

Starvation Ketosis

cause

A

1 caloric + glucose intake is insufficient
2 body begins to use fat stores for energy
3 fat metab incompletely
4 ketoacids accumulate in blood, causing METAB.ACIDOSIS

52
Q

excess removal or decrease in base is ____

A

metab acidosis

53
Q

Metabolic Acidosis

A

-relative excess of any acid except carbonic acid
or
-excess removal or decrease in base (bicarbonate)

54
Q

examples of excess removal of base that cause metab. acidosis

A

diarrhea

-loss of intestinal fluid that is rich in bicarbonate that originates fr pancreatic secretion

55
Q

hyperkalemia

A

high potassium;

metabolic acidosis

56
Q

metab alkalosis/decrease ina cid

clinical manifestations

A 
1 emesis (vomit)
2 hyperaldosteronism (decr in K, retention of Na + H2O)
3 hypokalemia (low K)

Pathophysiology (32 decks)

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