Acid and Base Flashcards
what are the main 2 organs which are involved in acid base balance
kidney and lungs.
what 3 components contribute to the daily acid production
total carbon dioxide
unmetabolised acids
plasma [H +]
how much carbon dioxide is produced in a day
25mol/day
how much unmetabolised acids are produced a day
50mmol/day
How much plasma [H+] is produced a day.
40 nmol/L
what effect will the wrong pH have upon proteins
It will cause them to denature.
what are the buffering solutions of maintaing the blood pH
haemoglobin bicarbonate phosphate proteins ammonia organic acids
define pH
concentration of hydrogen ions
what is the reference range fore [H+]
35-45 nmol/L
what is the reference range of pH
7.35-7.45
what is the name of the equation which is used to show the glance between H+ production and HCO3- reduction.
Henderson- Hasselbalch equation
what do H+ and HCO3- produce according to the henderson hasselbach equation.
carbon dioxide and water
when does the oxygen dissociation have a right shift
RIGHT
Right shift Increased 2,3, diPG, acidosis H+, Temperature (cold)
how is acid base balanced at the renal tubule
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-
how is acid base balanced at the renal tubule (ammonia)
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.
what happens at the dotal renal tubule which may affect the acid base balacne
Distal tubule k+/h+
Complete for excretion.
Increase hydrogen excretion acidosis
Increased potassium excretion alkalosis.
How is the acid base balanced in the GI system,
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.
what metabolism occurs in the liver which is related to acid base balance
dominant site of lactate metabolism
only site of urea synthesis- this maintains the hydrogen ion concentration.
what 2 components are all proteins and amino acids broken down into
carbon skeleton
amino acids
what is the main function of the liver in acids base balance
maintain the hydrogen ion concentration
If severe liver failure happens why happened to the molecules involved in acid base balance
NH4+ does not form glutamine.
NH4+ an HCO3- can therefore never make H+
what is the consequence of liver failure
alkalosis.
H+ not formed
define co-oximeter
machine which shows and measure abnormal haemoglobin
what measurement does a gas analyse not give
Bicarbonate
gives hydrogen, oxygen pressure and co2 pressure
what are the compensatory mechanisms for excess H+
respiratratory
renal bicarbonate regeneration
Hepatic shift between urea synthesis and ammonia excretion
what causes metabolic acidosis
increased H+ formation
acid ingestion
reduced renal H+ excretion
loss of bicarbonate
what causes metabolic alkalosis.
generation of HCO3- by gastric mucosa
renal generation of HCO3- in hypokalaemia.
administration of bicarbonate.
What are the consequences of metabolic alkalosis
K+ in cells and urine.
PO4 in cells.
Respiratory suppression- caused by vommitting and diahorrhea, ectopic ACTH in cushing’s syndrome.
what causes respiratory acidosis
CO2 retention due to 1: inadequate ventilation 2: parenchymal lung disease 3: inadequate perfusion • Breathlessness
what causes respiratory alkalosis
Increased CO2 excretion due to excessive ventilation producing alkalosis
• Acute asthma distress.
• CO2 excretion > CO2 production
what causes metabolic acidosis
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
what factors increase H+ formation
ketoacidosis, diabetic or alcoholic
lactic acidosis- symptom not diagnosis
poisoning
inherited organic acidosis
what causes lactic acidosis
shock
metabolic and toxic causes.
In alkalosis
increased glycolysis
reduced O2 delivery due to shift in O2 dissociation curve
lactate induced vasoconstriction
impaired mitochondrial respiration
how does renal failure result in increased acidosis
- Increased bicarbonate loss
- Reduced NH4+ excretion
- NH4+ to liver for urea + H+ synthesis
- only fraction of NH4+ derived from glutamine
in respiratory acidosis are the hydrogen, carbon dioxide and oxygen levels increased or decreased
hydrogen is high
carbon dioxide is high
oxygen is low
In respiratory alkalosis carbon dioxide and oxygen levels increased or decreased
hydrogen is low
carbon dioxide is low
oxygen is high
In metabolic acidosis carbon dioxide and oxygen levels increased or decreased
hydrogen is high
carbon dioxide is low
oxygen is high
in metabolic alkalosis carbon dioxide and oxygen levels increased or decreased
hydrogen is low
carbon dioxide is high
oxygen is low.
what mechanisms help to control hydrogen level
glutamine to ammonia in renal tubule
renal tubules and production of excess bicarbonate
excretion of hydrogen
bicarbonate in the blood.
what does liver failure cause
metabolic alkalosis
what does renal failure cause
metabolic acidosis.
what causes diabetic acidosis
hyperglycaemia
osmotic diuresis ——- to pre-renal uraemia
hyperketonaemia
increased FFA
What causes lactic acidosis
CO binds haemoglobin and doesn’t let go of it o the body has reduced oxygen carrying capacity.
what causes alcoholic acidosis
NAD+ depletion (thiamine) Thiamine deficiency (PDH co-factor) enhanced glycolysis for ATP formation keto-acids (b-HBD) 2 to counter-regulatory hormones profuse vomiting
