9 Acid-Base Balance Flashcards
Why is alkalaemia more dangerous than acidaemia?
Alkalaemia causes calcium ions to come out of solution and bind to other molecules
Why does alkalaemia increase neuronal excitability?
Lowers free calcium by causing Ca2+ ions to come out of solution
Also causes hypokalemia- more excitable state for neurons
What symptoms might someone get if their blood pH reach >7.45?
Parasthesia and tetany (intermittent muscular spasms)
Explain how acidaemia can cause arrhythmia. What other consequences can acidaemia have systemically?
- Increase K+ concentration in plasma
- Effects excitability of muscle (esp cardiac)
- Denatures proteins
- Affects glycolysis
- Hepatic function
What is the normal concentration of hydrogen carbonate in the blood? Where is it made and where is it controlled?
Why is hydrogen carbonate concentration in plasma not depleted when we produce acid due to metabolism?
- Kidney’s recover all filtered HCO3-
- HCO3- made:
- PCT: from amino acids- put NH4+ into urine
- DCT: from CO2 and H2O
How is hydrogen carbonate reabsorbed in the proximal convulted tubule?
- HCO3- in lumen of PCT
- Sodium- hydrogen exchanger- pumps hydrogen ions into lumen and sodium in
- H+ and HCO3- react to from H2O and CO2
- H2O and CO2 move into tubular cell
- Converted back into HCO3- - moves into ECF
How is HCO3- created from glutamine in the PCT?
(glutamine= an amino acid)
What happens to hydrogen ions and the hydrogen carbonate ions that are produced from the reaction of water and carbon dioxide in the distal tubules and collecting ducts?
Phosphate therefore used to create buffering system
Outline the role of ammonia in the control of pH.
pH drop- increase excretion of ammonia
ammonia buffers more hydrogen ions to form amonium- ammonium trapped
What is the minimum pH of urine? Why does the pH not go below this?
minimum pH: 4.5
doesn’t fall below: Due to buffering system (ie phosphate and ammonia if no HCO3-)
Why does acidosis result in hyperkalaemia?
Reciprocal ion shift
What effect will hypokalaemia have on acid base balance?
Will cause metabolic alkalosis- H+ ions move into cells
What causes these blood levels:
Hypoventilation
Hypercapnia
Respiratory acidosis
What causes these blood levels:
Hyperventilation
Hypocapnia
Respiratory alkalosis