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URN Biweekly 1 > Acid and Base Regulation- Almalouf > Flashcards

Acid and Base Regulation- Almalouf Flashcards

1
Q

H+ concentration is ____ across all body fluid compartments

A

the same

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2
Q

lungs excrete what

A

volatile acid

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3
Q

kidneys excrete what

A

fixed acid

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4
Q

most important ECF buffer

A

HCO3-

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5
Q

set point of pH

A

7.4

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6
Q

site of H+ secretion and HCO3- reabsorption

A

kidneys

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7
Q

site of CO2 exchange

A

lungs

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8
Q

acid body can get rid of easily

A

volatile

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9
Q

acids that kidneys have to eliminate

A

non-volatile

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10
Q

source of volatile acids

A

products of carb and fat metabolism

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11
Q

sources of non-volatile acids and bases

A

diet

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12
Q

our body has net production of acid or base

A

acid

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13
Q

western diet is _____-residue

A

acid

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14
Q

vegan diet is ____-residue

A

alkali

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15
Q

unifying mechanism of renal acid-base handling

A

H+ secretion

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16
Q

3 main functions of renal acid-base handling

A
  1. reclaim HCO3-
  2. excrete excess H+
  3. generate new HCO3-
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17
Q

where is HCO3- reabsorbed (reclaims HCO3-, no new HCO3- is made)

A

PCT

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18
Q

3 main transporters of PCT

A

lumen side: Na+/H+
blood side: Na+/K+ ATPase; Na+/HCO3-

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19
Q

3 main ways H+ can be excreted:

A
  1. free H+ ion
  2. phosphate anion
  3. ammonium
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20
Q

where H+ is put into lumen and body has phosphate ion to catch it

A

alpha intercalated cells of collecting duct

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21
Q

site where new HCO3- is formed and reabsorbed

A

alpha-intercalated cells of collecting duct

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22
Q

what hormone helps secrete H+ in exchange for K+ at alpha interacalated cells

A

aldosterone

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23
Q

NH4+ produced by what part of kidney

A

PCT

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24
Q

takes up NH4+ at Na+/K+/2Cl- and puts it in interstitium

A

Thick ascending limb

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25
Q

NH3 binds H+ and is excreted as NH4+ here

A

alpha intercalated cells

26
Q

new bicarbonate generated here

A

alpha intercalated cells of collecting duct

27
Q

UAG= unmeasured

A

NH4+

28
Q

UAG=

A

Na+ + K+ - Cl-

29
Q

UAG negative

A

kidneys responding well to eliminate H+

30
Q

UAG 0 or +

A

kidneys not responding well to eliminate H+

31
Q

primary change in HCO3-

A

metabolic disorder

32
Q

primary change in CO2

A

respiratory disorder

33
Q

too much CO2 in the blood

A

acidemia

34
Q

too little CO2 in the blood

A

alkalemia

35
Q

too much H+ and not enough HCO3-

A

metabolic acidosis

36
Q

too much HCO3- and too little H+

A

metabolic alkalosis

37
Q

(1st defense) ECF buffer defense against acid/base disorders

A

HCO3-; proteins; phosphate

38
Q

2nd defense against acid/base disorders

A

respiratory compensation (senses changes in CO2 and pH)

39
Q

(1st defense) ICF buffer defense against acid/base disorders

A

proteins, phosphate

40
Q

3rd defense against acid/base disorders

A

renal compensation (H+ or HCO3- secretion)

41
Q

an excess of H+ ion identified by reduction in ECF HCO3-

A

metabolic acidosis

42
Q

2 types of metabolic acidosis

A

high anion gap
normal anion gap

43
Q

metabolic anion gap=

A

Na+ - (Cl + HCO3)

44
Q

normal anion gap

A

10

45
Q

2 causes of normal anion gap metabolic acidosis

A

bicarbonate loss
failed H+ secretion

46
Q

what causes bicarbonate loss

A

diarrhea or PCT disease

47
Q

what causes failed H+ secretion

A

kidney disease or tubular disease

48
Q

high anion gap

A

> 10

49
Q

retained anion of introduced acid

A

high anion gap metabolic acidosis

50
Q

overall production of NH4+ is deficient (seen by reduced GFR and urinary NH4+)

A

chronic kidney disease

51
Q

failure of distal tubule H+ secretion into urine

A

type I renal tubular acidosis (DCT)

52
Q

failure of complete proximal tubule HCO3- rebasorption

A

type II renal tubular acidosis (PCT)

53
Q

insufficient aldosterone effect in distal tubule (meaning K+ is not being secreted)

A

type IV renal tubule acidosis (hyperkalemic distal RTA)

54
Q

used to diagnose metabolic acidosis

A

UAG (urinary anion gap)

55
Q

UAG=

A

Na+ + K+ - Cl-

56
Q

negative UAG

A

properly functioning kidney (NH4+ excretion)

57
Q

positive or 0 UAG

A

kidney not functioning properly (no NH4+ excretion)

58
Q

urine anion gap is strongly negative in what

A

non-renal acidosis

59
Q

what happens at the PCT during metabolic alkalosis

A

maintains high ECF HCO3- (absorb filtered HCO3-)

60
Q

what happens at distal tubule during metabolic alkalosis

A

contributes to ongoing HCO3- generation (through aldosterone effect)

61
Q

what is the kidney RESPONSE to metabolic alkalosis

A

beta intercalated cells excrete HCO3- in exchange for Cl-

62
Q

transporters of principal cells of collecting duct

A

ENaC +ROMK
Na+/K+ ATPase (K+ in and Na+ out)

URN Biweekly 1 (21 decks)

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