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MOD > Acid and Base > Flashcards

Acid and Base Flashcards

1
Q

what are the main 2 organs which are involved in acid base balance

A

kidney and lungs.

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2
Q

what 3 components contribute to the daily acid production

A

total carbon dioxide
unmetabolised acids
plasma [H +]

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3
Q

how much carbon dioxide is produced in a day

A

25mol/day

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4
Q

how much unmetabolised acids are produced a day

A

50mmol/day

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5
Q

How much plasma [H+] is produced a day.

A

40 nmol/L

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6
Q

what effect will the wrong pH have upon proteins

A

It will cause them to denature.

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7
Q

what are the buffering solutions of maintaing the blood pH

A 
haemoglobin
bicarbonate
phosphate
proteins
ammonia
organic acids
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8
Q

define pH

A

concentration of hydrogen ions

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9
Q

what is the reference range fore [H+]

A

35-45 nmol/L

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10
Q

what is the reference range of pH

A

7.35-7.45

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11
Q

what is the name of the equation which is used to show the glance between H+ production and HCO3- reduction.

A

Henderson- Hasselbalch equation

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12
Q

what do H+ and HCO3- produce according to the henderson hasselbach equation.

A

carbon dioxide and water

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13
Q

when does the oxygen dissociation have a right shift

A

RIGHT

Right shift Increased 2,3, diPG, acidosis H+, Temperature (cold)

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14
Q

how is acid base balanced at the renal tubule

A 
Na+ and HCO3- enter the renal tubule
Na+ is pumped out and H + is pumped in.
H+ combines with HCO3- forming H2CO3
this forms CO2 and H20
carbon dioxide is excreted
CO2 once again forms H2CO3 whig then splits into H+ and HCO3-
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15
Q

how is acid base balanced at the renal tubule (ammonia)

A

Na+ and HPO4- enter the renal tubule
Na+ is pumped out and H + is pumped in.
H+ combines with NH3 which is made from glutamine and then pumped in.

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16
Q

what happens at the dotal renal tubule which may affect the acid base balacne

A

Distal tubule k+/h+
Complete for excretion.
Increase hydrogen excretion acidosis
Increased potassium excretion alkalosis.

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17
Q

How is the acid base balanced in the GI system,

A

Hydrogen in stomach helps to breakdown food.

HCO3- in the pancreas helps to neutralise the acid of the pancreas to prevent the denaturing of pancreatic enzymes.

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18
Q

what metabolism occurs in the liver which is related to acid base balance

A

dominant site of lactate metabolism

only site of urea synthesis- this maintains the hydrogen ion concentration.

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19
Q

what 2 components are all proteins and amino acids broken down into

A

carbon skeleton

amino acids

20
Q

what is the main function of the liver in acids base balance

A

maintain the hydrogen ion concentration

21
Q

If severe liver failure happens why happened to the molecules involved in acid base balance

A

NH4+ does not form glutamine.

NH4+ an HCO3- can therefore never make H+

22
Q

what is the consequence of liver failure

A

alkalosis.

H+ not formed

23
Q

define co-oximeter

A

machine which shows and measure abnormal haemoglobin

24
Q

what measurement does a gas analyse not give

A

Bicarbonate

gives hydrogen, oxygen pressure and co2 pressure

25
Q

what are the compensatory mechanisms for excess H+

A

respiratratory
renal bicarbonate regeneration
Hepatic shift between urea synthesis and ammonia excretion

26
Q

what causes metabolic acidosis

A

increased H+ formation
acid ingestion
reduced renal H+ excretion
loss of bicarbonate

27
Q

what causes metabolic alkalosis.

A

generation of HCO3- by gastric mucosa
renal generation of HCO3- in hypokalaemia.
administration of bicarbonate.

28
Q

What are the consequences of metabolic alkalosis

A

K+ in cells and urine.
PO4 in cells.
Respiratory suppression- caused by vommitting and diahorrhea, ectopic ACTH in cushing’s syndrome.

29
Q

what causes respiratory acidosis

A 
CO2 retention due to 
1:	inadequate ventilation
2:	parenchymal lung disease
3:	inadequate perfusion
•	Breathlessness
30
Q

what causes respiratory alkalosis

A

Increased CO2 excretion due to excessive ventilation producing alkalosis
• Acute asthma distress.
• CO2 excretion > CO2 production

31
Q

what causes metabolic acidosis

A

Diabetes is not in control which results in renal function disturbance- quite common.
MI -CO binds haemoglobin and doesn’t let go of it o the body has reduced oxygen carrying capacity.
alcoholiC- NAD+ depletion (thiamine), thiamine deficiency (PDH co-factor), enhanced glycolysis for ATP formation, keto-acids (b-HBD) 20 to counter-regulatory hormones, profuse vomiting

32
Q

what factors increase H+ formation

A

ketoacidosis, diabetic or alcoholic
lactic acidosis- symptom not diagnosis
poisoning
inherited organic acidosis

33
Q

what causes lactic acidosis

A

shock

metabolic and toxic causes.

34
Q

In alkalosis

A

increased glycolysis
reduced O2 delivery due to shift in O2 dissociation curve
lactate induced vasoconstriction
impaired mitochondrial respiration

35
Q

how does renal failure result in increased acidosis

A
  • Increased bicarbonate loss
  • Reduced NH4+ excretion
  • NH4+ to liver for urea + H+ synthesis
  • only fraction of NH4+ derived from glutamine
36
Q

in respiratory acidosis are the hydrogen, carbon dioxide and oxygen levels increased or decreased

A

hydrogen is high
carbon dioxide is high
oxygen is low

37
Q

In respiratory alkalosis carbon dioxide and oxygen levels increased or decreased

A

hydrogen is low
carbon dioxide is low
oxygen is high

38
Q

In metabolic acidosis carbon dioxide and oxygen levels increased or decreased

A

hydrogen is high
carbon dioxide is low
oxygen is high

39
Q

in metabolic alkalosis carbon dioxide and oxygen levels increased or decreased

A

hydrogen is low
carbon dioxide is high
oxygen is low.

40
Q

what mechanisms help to control hydrogen level

A

glutamine to ammonia in renal tubule
renal tubules and production of excess bicarbonate
excretion of hydrogen
bicarbonate in the blood.

41
Q

what does liver failure cause

A

metabolic alkalosis

42
Q

what does renal failure cause

A

metabolic acidosis.

43
Q

what causes diabetic acidosis

A

hyperglycaemia
osmotic diuresis ——- to pre-renal uraemia
hyperketonaemia
increased FFA

44
Q

What causes lactic acidosis

A

CO binds haemoglobin and doesn’t let go of it o the body has reduced oxygen carrying capacity.

45
Q

what causes alcoholic acidosis

A 
NAD+ depletion (thiamine)
Thiamine deficiency (PDH co-factor)
enhanced glycolysis for ATP formation
keto-acids (b-HBD) 2 to counter-regulatory hormones
profuse vomiting

MOD (19 decks)

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