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Physiology > Acid Base > Flashcards

Acid Base Flashcards

1
Q

What are H+ donors?

A

Acids

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2
Q

What are H+ acceptors or give up OH- in solution?

A

Bases

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3
Q

What are examples of acids/bases that are strong (dissociate completely in solution)?

A

HCl, NaOH

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4
Q

What is an example of a weak acid/base (one that dissociates only partially in solution)?

A

Carbonic acid (H2CO3)

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5
Q

What is the holy-grail of acid-base?

A

H+

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6
Q

What is the physiologic pH range?

A

7.35-7.45

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7
Q

True or false: Small changes in pH can produce major disturbances in physiology.

A

True

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8
Q

Do most enzymes function within a very narrow or very broad pH range?

A

narrow

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9
Q

Acidosis is when pH is what?

A

below 7.35

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10
Q

Alkalosis is when pH is what?

A

above 7.45

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11
Q

What is the survival range of pH?

A

6.8-8.0

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12
Q

True or false: The body produces more acids than bases.

A

True

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13
Q

What two molecules join to form carbonic acid?

A

carbon dioxide and water

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14
Q

What enzyme is responsible for the creation of carbonic acid?

A

Carbonic anyhydrase

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15
Q

What are the products of the breakdown of carbonic acid?

A

Bicarbonate and hydrogen ion

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16
Q

How does the body obtain/create acids?

A
  • taken in with foods
  • produced by metabolism of lipids and proteins
  • cellular metabolism produces carbon dioxide
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17
Q

What is the volatilie acid of the lung?

A

CO2

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18
Q

Fixed acids of the kidney are non-volatile and include?

A
  • phosphoric acid
  • sulfuric acid
  • lactic acid
  • keto-acids
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19
Q

Phosphoric acid is produced from?

A

Membrane lipid breakdown

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20
Q

Sulfuric acid is produced from?

A

Protein breakdown

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21
Q

Lactic acid is produced from?

A

Ischemia, hypoxia

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22
Q

Keto-acids are produced from?

A

Disease (diabetes)

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23
Q

Buffers control what?

A

Acid production

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24
Q

What are buffers?

A

A mixture of a weak acid and conjugate base to resist a change in pH

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25
Q

Effective buffers have a pK within?

A

1.0 pH unit of 7.4

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26
Q

How do buffer systems resist a change in pH?

A

Take up H+ or release H+ as conditions change

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27
Q

Which buffer system is the first line of defense against pH shift?

A

Chemical Buffer system

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28
Q

The chemical buffer system has what three components?

A
  • bicarbonate buffer system
  • phosphate bufer system
  • protein buffer system
29
Q

Which buffer system is the second line of defense against pH shift?

A

physiological buffers

30
Q

What two components make up physiological buffers?

A
  • Respiratory mechanism (CO2 excretion)
  • Renal mechanism (H+ excretion)
31
Q

List the two extracellular buffers.

A
  • Bicarbonate (HCO3-)
  • Phosphate (H2PO4-)
32
Q

List the four intraceullular buffers.

A
  • bicarbonate-carbonic acid
  • hemoglobin (inside RBCs)
  • proteins (Imidazole of histidine and alpha amino acids)
  • organiz phosphates (ATP)
33
Q

What is the major intracellular buffer?

A

Phosphate buffer

34
Q

Body pH can be changed by doing what with breathing?

A

Changing rate and depth of breathing

35
Q

Exhalation of carbon dioxide can be used as a respiratory buffering mechanism, but only works with what type of acids?

A

Volatile acids (does NOT changed fixed acids, like lactic acid)

36
Q

If the kidneys fail, what also fails?

A

pH balance

37
Q

What is the purpose of renal buffering mechanisms?

A
  • eliminate large amounts of acid
  • excrete base
  • conserve and produce bicarbonate ions
38
Q

What are the three mechanisms renal buffering mechanisms use for the elimination of acid?

A
  • reabsorption of bicarbonate (HCO3-)
  • excretion of fixed acid (non-volatile acid) as titratable acid such as inorganic phosphate
  • excretion of fixed acid as ammonium (NH4+)
39
Q

If pH balance fails due to kidney failure what occurs?

A

acidemia

40
Q

What are the normal values of fixed H+ production, excretion of H+ as titrable acid, and excretion of H+ as NH4+?

A

Fixed production = 50mEq/day
Titratable acid = 20mEq/day
NH4+ = 30mEq/day

41
Q

If you are given the following values:

Total production of fixed H+ = 500mEq/day
Excretion of H+ as titratable acid = 100mEq/day
Excretion of H+ as NH4+ = 400mEq/day

What condition is this patient experiencing?

A

Diabetic Ketoacidosis

42
Q

If you are given the following values:

Total production of fixed H+ = 50mEq/day
Excretion of H+ as titratable acid = 10mEq/day
Excretion of H+ as NH4+ = 5mEq/day

What condition is this patient experiencing?

A

Chronic Renal Failure

43
Q

What are the two approaches of interpreting acid-base abnormalities?

A
  • traditional
  • stewart
44
Q

What is analyzed in the traditional method of acid base interpretation?

A
  • base excess
  • bicarbonate
  • PCO2
45
Q

What is analyzed in the stewart method of acid base interpretation?

A
  • pH determined by independent variable
  • independent variables include PCO2 and cation-anion difference
46
Q

At what point is compensation for acid-base imbalance complete?

A

if pH is brought back WNL

47
Q

Is partial compensation of pH range still outside normal limits?

A

Yes

48
Q

If the primary problem is metabolic, what type of compensation is used?

A

respiratory compensation (hyperventilation or hypoventilation)

49
Q

If the primary problem is respiratory, what type of compensation is used?

A

Metabolic compensation (renal mechanisms)

50
Q

What is the rate of respiratory compensation mechansisms?

A

severl minutes to hours

51
Q

What is the rate of metabolic (renal) compensation mechanisms?

A

several hours to days

52
Q

What is the compensatory reponse to non-respiratory acidemia?

A

hyperventilation
(increase bicarbonate reabsorption)

53
Q

What is the compensatory response to respiratory acidemia?

A
  • chemical buffering if acute
  • renal regulation if chronic
    (increase bicarbonate reabsorption)
54
Q

What is the compensatory response to non-repiratory alkalemia?

A

hypoventilation
(increase bicarbonate excretion)

55
Q

What is the compensatory response to respiratory alkalemia?

A
  • chemical buffering if acute
  • renal regulation if chronic
    (decrease bicarbonate reabsorption)
56
Q

If given decreased bicarbonate as primary disturbance and decreased PCO2 as compensation, what is the acid base disturbance?

A

Metabolic acidosis

57
Q

If given increased bicarbonate as primary disturbance and increased PCO2 as compensation, what is the acid base disturbance?

A

Metabolic alkalosis

58
Q

If given increased PCO2 as primary disturbance and increased bicarbonate as compensation, what is the acid base disturbance?

A

Respiratory acidosis

59
Q

If given decreased PCO2 as primary disturbance and decreased bicarbonate as compensation, what is the acid base disturbance?

A

Respiratory alkalosis

60
Q

Diabetic ketoacidosis, lactic acidosis, salicylate poisoning, methanol/formaldehyde poisoning, and ethylene glycol poisoning can cause what?

A

excessive production or ingestion of fixed H+ which results in metabolic acidosis

61
Q

Diarrhea and type 2 renal tubular acidosis can cause what?

A

Loss of bicarbonate which will result in metabolic acidosis

62
Q

Chronic renal failure, type 1 renal tubular acidosis, and type 4 renal tubular acidosis can cause what?

A

inability to excrete fixed H+ which will result in metabolic acidosis

63
Q

What are the five steps to acid base interpretation?

A
  • determine pH
  • determine PCO2 and HCO3 values
  • determine primary and compensatory shift
  • determine respiratory component of pH change
  • calculate PaO2/FiO2 ratio
64
Q

For respiratory component of acid-base change, the pH decreases how many units for every 10 increase in PaCO2 above 40mmHg?

A

0.05 units

65
Q

What is the normal PaO2/FiO2 ratio?

A

> 400

66
Q

A PaO2/FiO2 ratio less than 200 indicates what?

A

severe pulmonary disease (respiratory failure)

67
Q

What is the anion gap (AG) equation?

A

AG = [Na+] + [K+] - [Cl-]

68
Q

What is the strong ion difference (SID) equation?

A

SID = [Na+] + [K+] - [Cl-] - [lactate]

Physiology (18 decks)

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