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Clinical Biochem > Acid/Base > Flashcards

Acid/Base Flashcards

1
Q

What is the ref range for blood conc?

A

35-45 nmol/L

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2
Q

What is the Henderson-Hasslebach equation?

A

pH =pKa + Log ([A-]/[HA])
- the lower the pKa value the stronger the acid

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3
Q

Describe Alkalosis

A
  • condition where the body fluids have the excess base alkali
  • decreased CO2 or increased bicarbonate in blood
  • examples = respiratory, metabolic, hypokalemic
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4
Q

Describe Acidosis

A
  • when your body fluids contain too much acid
  • it occurs when your kidney & lungs can’t balance pH
  • types = respiratory & metabolic
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5
Q

What is the first line of defence against a pH shift?

A

Chemical buffer system
- bicarbonate buffer
- phosphate buffer
- protein buffer

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6
Q

What is the 2nd line of defence against pH shifts?

A

physiological buffers
- respiratory mechanism (CO2 excretion)
- renal mechanism
(H+ excretion)

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7
Q

Describe Carbonic Anhydrase

A
  • enzyme found in RBCs, gastric mucosa, pancreatic cells & renal tubules
  • carbonic acid is converted into CO2 & H2O by this enzyme
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8
Q

What regulates the elimination of CO2 in the lungs ?

A

the respiration rate

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9
Q

What happens when there is a rise in CO2 levels?

A
  • rise in CO2 = low pH which is detected by chemoreceptors in the medulla oblongata, carotid & aortic body
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10
Q

What can a decreased ventilation efficiency result in?

A
  • CO2 retention in blood
  • along with increased in blood conc - acidosis may occur
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11
Q

What the renal control of the acid base balance ?

A
  1. filtration
  2. reabsorption
  3. secretion
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12
Q

Describe filtration in renal control of acid/base balance

A

In the glomerulus, blood plasma & other dissolved substances get filtered into the glomerular capsule

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13
Q

Describe reabsorption in renal control of acid/base balance

A

all along the renal tubule & collecting duct, water, ions & other substances get reabsorbed from the renal tubule lumen into the peritubular capillaries & ultimately into the blood

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14
Q

Describe Secretion in the renal control of acid/base balance

A
  • along the renal tubule & collecting duct, substances like wastes, drugs & excess ions are secreted from the peritubular capillaries into the renal tubule
  • these substances eventually make their way to the urine
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15
Q

What is the consequence of bicarbonate entering the lumen of the proximal tubule ?

A
  • its unable to escape
  • it can’t be reabsorbed directly
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16
Q

What are the consequences of acidosis ?

A
  • raised CO2
  • Raised H+ in plasma
17
Q

Describe normal lung function

A
  • expels CO2 & push equilibrium to the left
  • greater formation of carbonic acid
  • pH in plasma raised
  • depletes H+ conc.
18
Q

What are some causes of metabolic acidosis ?

A
  • increased production of H+
  • ingestion of drugs metabolised to acids
  • impaired excretion of H+ via kidneys
  • loss of bicarbonate in urine or GI tract
19
Q

What are the lab findings for acute metabolic acidosis ?

A

pH = decreased
pCO2 = normal
[HCO3] = decreased

20
Q

What are the lab findings for compensated metabolic acidosis ?

A

pH = normal
pCO2 = decreased
[HCO3] = decreased

21
Q

What are the causes of metabolic alkalosis ?

A
  • loss of hydrogen ions in vomit
  • potassium deficiency
  • large doses of an alkali-sodium bicarbonate
22
Q

What are the lab findings for acute metabolic alkalosis ?

A

pH = increased
pCO2 = normal
[HCO3] = increased

23
Q

What are the lab findings of compensated metabolic alkalosis ?

A

pH = normal
pCO2 = normal/slight increase
[HCO3] = marked increase

24
Q

Define COPD

A

Chronic Obstructive Pulmonary Disease
- flow of air into & out of the lungs is impaired

25
Q

What are the 3 mechanisms of airway obstruction?

A
  1. lumen partially occluded by excessive secretions
  2. causes in the wall of the airway
  3. outside the airway destruction of the paranchyma may cause loss of elasticity & narrowing
26
Q

Describe acute cases of respiratory acidosis

A
  • acute within minutes or hours
  • non-compensated as it can take 48-72 hours for bicarbonate reabsorption to occur
  • hypoventilation = an increase in pCO2 & H+ will rise in the blood
27
Q

What are the lab findings for acute respiratory acidosis ?

A

pH = low
pCO2 = increased
[HCO3] = normal/slight increase

28
Q

What are the lab findings for compensated respiratory acidosis ?

A

pH = normal
pCO2= increased
[HCO3] = increased

29
Q

Describe respiratory alkalosis

A
  • less common
  • acute no renal compensation
  • hysterical over-breathing
    -hypoxia
  • raised intracranial pressure

Clinical Biochem (13 decks)

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