Acid and Base Regulation- Almalouf

Question 1

H+ concentration is ____ across all body fluid compartments

Answer 1

the same

Question 2

lungs excrete what

Answer 2

volatile acid

Question 3

kidneys excrete what

Answer 3

fixed acid

Question 4

most important ECF buffer

Answer 4

HCO3-

Question 5

set point of pH

Answer 5

7.4

Question 6

site of H+ secretion and HCO3- reabsorption

Answer 6

kidneys

Question 7

site of CO2 exchange

Answer 7

lungs

Question 8

acid body can get rid of easily

Answer 8

volatile

Question 9

acids that kidneys have to eliminate

Answer 9

non-volatile

Question 10

source of volatile acids

Answer 10

products of carb and fat metabolism

Question 11

sources of non-volatile acids and bases

Answer 11

diet

Question 12

our body has net production of acid or base

Answer 12

acid

Question 13

western diet is _____-residue

Answer 13

acid

Question 14

vegan diet is ____-residue

Answer 14

alkali

Question 15

unifying mechanism of renal acid-base handling

Answer 15

H+ secretion

Question 16

3 main functions of renal acid-base handling

Answer 16

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

Question 17

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

Answer 17

PCT

Question 18

3 main transporters of PCT

Answer 18

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

Question 19

3 main ways H+ can be excreted:

Answer 19

1. free H+ ion
2. phosphate anion
3. ammonium

Question 20

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

Answer 20

alpha intercalated cells of collecting duct

Question 21

site where new HCO3- is formed and reabsorbed

Answer 21

alpha-intercalated cells of collecting duct

Question 22

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

Answer 22

aldosterone

Question 23

NH4+ produced by what part of kidney

Answer 23

PCT

Question 24

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

Answer 24

Thick ascending limb

Question 25

NH3 binds H+ and is excreted as NH4+ here

Answer 25

alpha intercalated cells

Question 26

new bicarbonate generated here

Answer 26

alpha intercalated cells of collecting duct

Question 27

UAG= unmeasured

Answer 27

NH4+

Question 28

UAG=

Answer 28

Na+ + K+ - Cl-

Question 29

UAG negative

Answer 29

kidneys responding well to eliminate H+

Question 30

UAG 0 or +

Answer 30

kidneys not responding well to eliminate H+

Question 31

primary change in HCO3-

Answer 31

metabolic disorder

Question 32

primary change in CO2

Answer 32

respiratory disorder

Question 33

too much CO2 in the blood

Answer 33

acidemia

Question 34

too little CO2 in the blood

Answer 34

alkalemia

Question 35

too much H+ and not enough HCO3-

Answer 35

metabolic acidosis

Question 36

too much HCO3- and too little H+

Answer 36

metabolic alkalosis

Question 37

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

Answer 37

HCO3-; proteins; phosphate

Question 38

2nd defense against acid/base disorders

Answer 38

respiratory compensation (senses changes in CO2 and pH)

Question 39

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

Answer 39

proteins, phosphate

Question 40

3rd defense against acid/base disorders

Answer 40

renal compensation (H+ or HCO3- secretion)

Question 41

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

Answer 41

metabolic acidosis

Question 42

2 types of metabolic acidosis

Answer 42

high anion gap normal anion gap

Question 43

metabolic anion gap=

Answer 43

Na+ - (Cl + HCO3)

Question 44

normal anion gap

Answer 44

10

Question 45

2 causes of normal anion gap metabolic acidosis

Answer 45

bicarbonate loss failed H+ secretion

Question 46

what causes bicarbonate loss

Answer 46

diarrhea or PCT disease

Question 47

what causes failed H+ secretion

Answer 47

kidney disease or tubular disease

Question 48

high anion gap

Answer 48

>10

Question 49

retained anion of introduced acid

Answer 49

high anion gap metabolic acidosis

Question 50

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

Answer 50

chronic kidney disease

Question 51

failure of distal tubule H+ secretion into urine

Answer 51

type I renal tubular acidosis (DCT)

Question 52

failure of complete proximal tubule HCO3- rebasorption

Answer 52

type II renal tubular acidosis (PCT)

Question 53

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

Answer 53

type IV renal tubule acidosis (hyperkalemic distal RTA)

Question 54

used to diagnose metabolic acidosis

Answer 54

UAG (urinary anion gap)

Question 55

UAG=

Answer 55

Na+ + K+ - Cl-

Question 56

negative UAG

Answer 56

properly functioning kidney (NH4+ excretion)

Question 57

positive or 0 UAG

Answer 57

kidney not functioning properly (no NH4+ excretion)

Question 58

urine anion gap is strongly negative in what

Answer 58

non-renal acidosis

Question 59

what happens at the PCT during metabolic alkalosis

Answer 59

maintains high ECF HCO3- (absorb filtered HCO3-)

Question 60

what happens at distal tubule during metabolic alkalosis

Answer 60

contributes to ongoing HCO3- generation (through aldosterone effect)

Question 61

what is the kidney RESPONSE to metabolic alkalosis

Answer 61

beta intercalated cells excrete HCO3- in exchange for Cl-

Question 62

transporters of principal cells of collecting duct

Answer 62

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