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Maddy - Renal II > Acid-Base > Flashcards

Acid-Base Flashcards

1
Q

what is the significance of glutamine in ammonia buffering

A

glutamine has two ammonia groups that it breaks down and releases in the tubular fluid

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2
Q

how does decrease in PaCO2 affect H+ secretion

A

decreases H+ secretion

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3
Q

how does an increase in angiotensin II affect H+ secretion

A

increases H+ secretion

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4
Q

renal compensation for respiratory alkalosis

A

decrease bicarbonate and decrease acid excretion in the urine

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5
Q

pH range of intracellular fluid

A

6.0-7.4

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6
Q

what change in pH is needed to double or half the hydrogen concentration

A

0.3

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7
Q

how does increase in plasma HCO3 affect H+ secretion

A

decreases H+ secretion

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8
Q

what happens to the hydrogen concentration in the ICF in acidemia

A

increases (takes in H+)

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9
Q

what happens to the hydrogen concentration in the ICF in alkalemia

A

decreases (donates H+)

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10
Q

how does a decrease in ECF volume affect H+ secretion

A

increases H+ secretion

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11
Q

what are the two ways ammonia can cross the apical membrane

A

through an ammonia/Na+ transporter

passively

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12
Q

renal compensation for respiratory acidosis

A

increase bicarbonate and increase acid excretion in the urine

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13
Q

how does an increase in ECF volume affect H+ secretion

A

decreases H+ secretion

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14
Q

how does decrease in plasma HCO3 affect H+ secretion

A

increases H+ secretion

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15
Q

how does hypokalemia affect H+ secretion

A

increases H+ secretion

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16
Q

causes of respiratory alkalosis

A

hypoxia

anxiety (hyperventilation)

progesterone

aspirin poisoning

ventilators

high altitude

17
Q

pH of venous blood and interstitial fluid

A

7.35

18
Q

how does increase in filtered load of HCO3- affect H+ secretion

A

increases H+ secretion

19
Q

how does hyperkalemia affect H+ secretion

A

decreases H+ secretion

20
Q

why is ammonium not a titratable acid

A

because of the high pK of NH4+ means that no H+ is removed from NH4+ during titration to a pH of 7.4

21
Q

main causes of high anion gap metabolic acidosis

A

DKA

ethanol

lactic acidosis

opiates

aspirin

22
Q

main causes of non-anion gap metabolic acidosis

A

diarrhea

spironolactone

post-hypocapnia

23
Q

how does bicarbonate help carry Na+ out of the cell and into the blood in the proximal tubule

A

through the HCO3-/Na+ symporter - passively diffuses to promote Na+ transport

24
Q

3 ways in which CO2 is transported

A

7% dissolved

23% w/ hemoglobin

70% as bicarbonate

25
Q

respiratory and renal compensation for metabolic alkalosis

A

hypoventilation, or longer breaths

decrease bicarbonate regeneration and decrease acid excretion in urine

26
Q

pH of arterial blood

A

7.40

27
Q

main causes of metabolic alkalosis

A

vomiting

licorice

post-hypercapnia

diuretics

hyperaldosteronism

loop or thiazide diuretics

28
Q

what is net acid excretion made of

A

1/3: titratable acids (primarily phosphate and salts with a pka < 7.4)

2/3: NH4+

29
Q

where is bicarbonate reabsorbed

A

85% PCT 10% TAL 4.9% CT 0.1% urine

30
Q

respiratory and renal compensation for metabolic acidosis

A

hyperventilation

increase bicarbonate regeneration and increase acid excretion in the urine

31
Q

how does increase in PaCO2 affect H+ secretion

A

increases H+ secretion

Maddy - Renal II (6 decks)

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