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physiology 2 > acid-base balance > Flashcards

acid-base balance Flashcards

1
Q

proton regulation

A

must be tightly regulated because very reactive
ECF levels kept al low levels, 4nEq/L
should be 3-5nEq/L

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2
Q

pH of ECF

A

7.4

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3
Q

acidosis

A

process

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4
Q

acidaemia

A

state

<7.35

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5
Q

alkalosis

A

process

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6
Q

alkalaemia

A

state

>7.45

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7
Q

venous blood compared to arterial blood

A

more acidic

higher partial pressure of carbon dioxide

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8
Q

interstitial fluid

A

usually same an venous blood pH

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9
Q

pH effects of metabolism

A

practically every step of every metabolic process is pH dependant
deviate from optimal pH causes decrease in reaction efficiency, especially due to compromised enzyme activity

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10
Q

acidosis affect on neuromuscular system

A

inhibitory

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11
Q

alkalosis affect of neuromuscular system

A

excitatory

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12
Q

why does pH affect neuromuscular system

A

plasma Ca2+ binding to albumin is pH dependant
acidosis increases free Ca2_
bathmotropy - calcium blocks Na channels, raises AP threshold

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13
Q

bathmotropy

A

when free calcium interacts with Na channels and switches them off, which raises the AP threshold

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14
Q

potassium balance in pH

A

acidosis - more serum [K]

alkalosis - less serum K

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15
Q

consequences of acidosis

A

headaches, confusion, lethargy, tremors, sleepiness, cerebral dysfunction,
come
hyperventilation

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16
Q

consequences of alkalosis

A

muscular weakness, pain, cramps, spasms, (smooth and skeletal muscle), tetany
hypoventilation

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17
Q

most acid comes from

A

CHO/fat metabolism (CO2)

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18
Q

acids produced in the body

A
  • metabolic activities continuously add H to the body
  • glycolytic metabolism - lactic acid
  • oxidative metabolism - CO2/carbonic acid
  • FA/AA metabolism - ketoacids
  • inorganic acids produced from intermediary metabolism
  • stomach acid production loads HCO3 - blood
  • pancreatic HCO3 production loads H+ - blood
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19
Q

vomiting causes

A

alkalosis

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20
Q

buffers

A

HCO3- in ECF
proteins, haemoglobin, phosphates in cells
phosphates, ammonia in urine

21
Q

chemical buffering

A
  • solutions preventing change in pH
  • intracellular and extracellular buffers provide an immediate response to acid-base disturbances
  • bonde also buffers acid loads
  • immediate but exhaustible
22
Q

pulmonary regulation

A
  • PCO2 is regulated by changes in tidal volume and respiratory rate
  • CO2 is exhaled - blood pH increases
  • can only removed acid
23
Q

renal regulation

A
  • kidneys control adjust the amount of HCO3- and/or H+ that is excreted
  • excreting HCO3- causes decrease in blood pH
  • excreting H + causes increase in blood pH
24
Q

buffer power

A
  • determined by the pH appropriateness of the system

- pKa should patch pH

25
Q

capacity of buffer determined by

A

total [buffer]

relative [HB] and [B]

26
Q

chemical buffer systems

A

HCO3- (ECF buffer)
NH3 (renal tubular fluid)
PO42- (ICF)
proteins (ICF, Hb n RBCs)

27
Q

ventilation

A

ventilation rates control pH balance

- increased ventilation removes CO2

28
Q

hyperventilation causes

A

increase pH

decrease [H]

29
Q

hypoventilation causes

A

increase [H]

decrease pH

30
Q

renal control

A

kidneys constantly remove HCO3- from blood
to maintain balance, we must re absorb HCO3- back into the blood
kidneys can’t do that
first it has to be converted

31
Q

conversion of HCO3- for reabsorption

A

HCO3- + H+ > H2CO3 > H2O + CO2

to do this, kidney must secrete H+ at a 1:1 ration with HCO3-

32
Q

if H secretion = HCO3- filtration

A

no change in pH

33
Q

if H secretion > HCO3- filtration

A

acid loss

34
Q

if H secretion < HCO3- filtration

A

base loss

35
Q

how is HCO3- reabsorbed

A

2nd degree active transport

  • CO2 diffuses into cells
  • carbonic anhydrase inside the cell forms CO2 into H2CO3 which becomes HCO3- and H+
  • the H+ then leaves the cell again

1st degree active transport
- H+ pumped directly put into the lumen

36
Q

acid being secreted as ammonium

A

ammonium is produced by removing amine group from amino acids
amine group is actively transported out of the cells as ammonium via counter transportation for Na

37
Q

2 direct mechanisms

A
  1. Na/K ATPase - alkalosis causes a shift of K+ from the plasma > ICF
  2. electronuetrality - K+ will be passively secreted as an obligate cation partner to HCO3-
38
Q

why do states of alkalosis cause hypokalaemia

A

because K+ ions are being secreted with the HCO3- ions to maintain electronuetrality

39
Q

arterial blood gas analysis

A

PCO2 - reflect respiratory component

HCO3- - reflects the metabolic component

40
Q

AB disorders

A
  • may be metabolic or respiratory
  • metabolic - due to production, ingestion or loss of acids/bases
  • respiratory - due to hyper/hypoventilation
41
Q

riased HCO3-

A

alkalosis

42
Q

raised pCO2

A

acidosis

43
Q

respiratory disorder leads to

A

metabolic compensation

44
Q

metabolic disorder

A

respiratory compensation

45
Q

subtypes of metabolic acidosis

A

[Na+] is greater than [HCO3-] + [Cl-]
difference between the two issues the anion gap
usually 12 mEq/L
major increase in anion gap implies existence of an organic acidosis (poisoning)

46
Q

plasma anion gap exists because

A
  • gap exists because there must be elctronuetrality
47
Q

increased anion gap

A

organic acidosis
diabetic/sstarvation ketoacidosis, lactic acidosis, poisoning sulphates, methanol, ethylene glycol, os salicylates (aspirin)

48
Q

normal anion gap acidosis

A

diarrhoea (HCO3- loss)

carbonic anhydrase-inhibitors

physiology 2 (21 decks)

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