acid-base Flashcards

1
Q

what is pH?

A

-a measurement of its H+ concentration
-pH of 7 is neutral, if a solution is below 7.0 the H concentration is greater than 1x10e-7 M and considered acidic
-if a solution is above 7.0 it has a H below 1x10e-7 M and is considered alkaline (basic)
-a change of 1 pH unit represents a 10-fold change in H concentration

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2
Q

what is normal pH in the body?

A

-the H concentration of normal arterial plasma is 0.00004 mEq/L (very small compared to other ions, Na 140mmol/L) and is usually expressed on a logarithmic pH scale of 0-14
-normal pH of the body is 7.40, slightly alkaline (7.38-7.42)

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3
Q

how do pH changes denature proteins?

A

-pH is closely regulated, intracellular proteins such as enzymes and membrane channels are sensitive to changes in pH
-function of these proteins depend on their normal three-dimensional structure
-changes in H concentration results in disruptions in hydrogen bonds altering, altering the structure

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4
Q

what is acidosis and alkalosis?

A

-acidosis: very low pH (excess H)=CNS depression, confusion, coma
-alkalosis: high pH (low H)= hyperexcitability in sensory neurons and muscles, sustained respiratory muscle contraction

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5
Q

what is the daily challenges of the body regarding pH?

A

-in day to day functioning, the body is challenged by intake and production of acids more than bases

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6
Q

what is acid input a result of?

A

-diet as well as acids produced during metabolism
-the largest source of acid on a daily basis is from CO2 from aerobic metabolism

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7
Q

pH homeostasis depends on three mechanisms:

A
  1. Buffers (first line of defense)
  2. ventilation (handles 75% of disturbances)
  3. renal regulation of H and HCO3- (slowest)
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8
Q

what are buffers?

A

-include proteins, phosphate ions and HCO3-
-a buffer is a molecule that moderates, but does not prevent changes in pH by combining with or releasing H
-in the absence of a buffer, adding acid to a solution causes a sharp change in pH
-in the presence of buffers, the H added is bound and pH change is slightly moderated or may even be unoticeable

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9
Q

where are buffers found?

A

within cells and in the plasma
-intracellular buffers include cellular proteins (hemoglobin), phosphate ions (HPO4, H2PO4)

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10
Q

what do buffers systems in the blood result in?

A

-in a large amount of HCO3-, the most important extracellular buffer system (can now buffer H from non-respiratory sources)

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11
Q

what is the HCO3- plasma concentration?

A

-plasma HCO3- concentration is approximately 600,000 times concentrated as plasma H (H bound to Hb)
-the relationship between CO2, HCO3- and H in the plasma is expressed by

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12
Q

how does the law of mass action relate to HCO3-?

A

-according to law of mass action, any change in amount of CO2, HCO3- or H in solution causes reaction to shift until new equilibrium is reached

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13
Q

what shifts the HCO3- equation to the right and left?

A
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14
Q

what do peripheral and central chemoreceptors do for pH?

A

-sense changes in plasma PCO2 and/or H and signal to the respiratory control center to adjust ventilation accordingly

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15
Q

how does ventilation help pH?

A

-compensates for pH disturbances
-alterations in ventilation can correct disturbances in acid-base balance as well as cause them

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16
Q

what handles the remaining 25% of pH disturbances?

A

-the kidneys handle it slowly
-use ammonia and phosphate buffers

17
Q

what are the two mechanisms that the kidneys use to handle pH disturbances

A
  1. directly, by altering the rates of excretion or reabsorption of H
  2. indirectly, by changing the rate at which HCO3- buffer is reabsorbed or excreted
18
Q

what do the kidneys do during acidosis?

A

-in general, during acidosis, excess H is buffered by ammonia within tubule cells or enters lumen and is buffered by phosphate ions
-H is not filtered, enters tubules via secretion only

19
Q

how does the proximal tubule secrete H and reabsorb HCO3-?

A

-high amount of HCO3- filtered
-no apical HCO3 transporter so it occurs via indirect methods

20
Q

what controls acid excretion?

A

the distal nephron
-initial portion of the collecting duct plays a significant role in the fine regulation of acid-base balance

21
Q

what does the collecting duct do when in acidosis and alkalosis?

A

acidosis (Type A): intercalated cells function to increase H secretion and HCO3- reabsorption
-usually accompanied by increase K reabsorption (hyperkalemia)

alkalosis (Type B): intercalated cells function to increase H reabsorption and HCO3- secretion
-usually accompanied by increase K secretion (hypokalemia

22
Q

how can acid-base disturbances be classified?

A

-three compensatory mechanisms (buffers, ventilation and renal excretion) take care of most variations in plasma pH
-can be classified by both the direction of the pH change (acidosis or alkalosis) and by the underlying cause (metabolic or respiratory)
-by the time an acid-base disturbance causes a change in plasma pH, the body’s buffers are ineffective leaving respiratory and renal compensation to alleviate the change in pH

23
Q

what are the categories of acid/base disturbances?

A

-respiratory acidosis
-respiratory alkalosis
-metabolic acidosis
-metabolic alkalosis

24
Q

respiratory induced changes in pH must be resolved via _____________

A

renal mechanisms

25
Q

what is respiratory acidosis?

A

-occurs when alveolar hypoventilation results in CO2 retention and elevated plasma CO2
-because of respiratory origin, compensation must occur via renal mechanisms (excrete H, reabsorb HCO3-)

26
Q

what is respiratory alkalosis?

A

-much less common, occurs as a result of hyperventilation in the absence of increased metabolic CO2 production
-compensation occurs via renal HCO3- excretion and H reabsorption

27
Q

what is metabolic acidosis?

A

-occurs when dietary and/or metabolic input of H exceeds H excretion
-lactic acidosis as a result of anaerobic metabolism
-ketoacidosis from excessive breakdown of fats and amino acids
-can also occur from excessive HCO3 loss (diarrhea)

28
Q

what is metabolic alkalosis?

A

-two common causes: excessive vomiting of acidic stomach contents or excessive ingestion of bicarbonate-containing antacids
-usually rapidly resolved by decrease in ventilation, but effectiveness is limited because it can cause hypoxia
-renal response: HCO3- excreted, H reabsorbed