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Acid-Base Balance > Acid-Base Balance > Flashcards

Acid-Base Balance Flashcards

1
Q

Blood buffering system equation

A

CO2 + H2O = HCO3- + H+

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2
Q

What is the purpose of the Henderson-Hasselbalch equation?

A

Relates the pH to the ratio between the concentration of bicarbonate and the partial pressure of CO2

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3
Q

What does the Henderson-Hasselbalch equation show?

A

blood pH is driven by the ratio between bicarbonate production and partial pressure of CO2

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4
Q

What would the effect on blood pH be if bicarbonate levels increase?

A

increase

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5
Q

What would the effect on blood pH be if partial pressure of CO2 increases?

A

decrease

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6
Q

What is the usual range of pH?

A

7.35-7.45

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7
Q

When does respiratory acidosis occur?

A

Increase in blood CO2 due to respiratory system disorder

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8
Q

Causes of respiratory acidosis

A
  • respiratory depression by opiates
  • disorders of the respiratory muscles (e.g. polio)
  • airway obstructions (e.g. sleep apnoea)
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9
Q

How does the body counteract respiratory acidosis?

A

Kidneys excrete more H+ and increase bicarbonate reabsorption

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10
Q

What are the causes for respiratory alkalosis?

A

Hyperventilation due to:

  • hypoxaemia from high altitude
  • pulmonary embolism
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11
Q

How does the body counteract respiratory alkalosis?

A

Kidney reabsorbs H+ ions

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12
Q

How does the urinary system alter blood pH?

A
  • excretion of H+

- production and reabsorption of HCO3-

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13
Q

How are H+ ions excreted?

A

In the form of:

  • dihydrogen phosphate (H2PO4-)
  • ammonium (NH4+)
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14
Q

Explain the mechanism of H+ ions in the form of dihydrogen phosphate

A
  1. H+ ions actively transported into lumen via hydrogen-ATPase pumps
  2. Excess luminal phosphate can bind a large portion of H+
  3. This buffers them as H2PO4- before excretion
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15
Q

Explain the mechanism of excretion of H+ ions in the form of ammonium

A
  1. Glutamine -> glutamate + ammonium (PCT)
  2. Ammonium dissociates -> ammonia + H+
  3. Ammonia enters lumen (as it can pass membrane)
  4. Ammonia -> ammonium (by picking up luminal H+)
  5. Allows hydrogen to be excreted as ammonium ions
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16
Q

What can ammonia secreted at the PCT be used for?

A

Buffer and secrete H+ in the collecting duct

17
Q

What can the glutamate created from glutamine be used for?

A

Forming bicarbonate

18
Q

Where can bicarbonate ions be reabsorbed?

A

proximal convoluted tubule

19
Q

Explain the mechanism of bicarbonate reabsorption

A
  1. H+ secreted into lumen to combine with filtered bicarbonate -> carbonic acid
  2. Carbonic acid -> CO2 + H2O
  3. Inside the cell, carbonic anhydrase converts CO2 + H2O -> carbonic acid
  4. Carbonic acid -> H+ + HCO3-
  5. HCO3- transported into blood
  6. H+ transported into lumen to repeat cycle
20
Q

Explain the mechanism of bicarbonate production

A
  1. Metabolic activity of cells produces large amounts of CO2
  2. CO2 + H2O -> HCO3- + H+
  3. HCO3- enters the plasma
  4. H+ transported into lumen to drive HCO3- reabsorption
21
Q

What other substrate can produce bicarbonate, and what is the byproduct?

A

amino acids

ammonium ions

22
Q

What is the anion gap?

A

Way of determining the cause of a metabolic acidosis

23
Q

What is the anion gap formula?

A

(Na+ + K+) - (Cl- + HCO3-)

24
Q

When does metabolic acidosis occur?

A

pH blood < 7.35

25
Q

What are the general causes of metabolic acidosis?

A
  • increase in H+, lactate and organic acids

- loss of HCO3-

26
Q

What are the symptoms of metabolic acidosis?

A
  • hyperventilation
  • confusion
  • tachycardia
27
Q

How would you diagnose metabolic acidosis/alkalosis?

A

arterial blood gas analysis

28
Q

When does metabolic alkalosis occur?

A

pH blood > 7.45

29
Q

What are the general causes of metabolic alkalosis?

A
  • massive loss of H+

- increase of HCO3-

30
Q

What are the symptoms of metabolic alkalosis?

A
  • hypoventilation
  • confusion
  • tetany
  • tremor

Acid-Base Balance (1 decks)

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