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PHS 3300 > Acid Base Balance > Flashcards

Acid Base Balance Flashcards

(90 cards)

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1
Q

what happens to the pH as H+ increases

A

it decreases

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2
Q

what is the normal arterial pH

A

7.40

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3
Q

what is the normal range of arterial pH

A

7.35-7.45

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4
Q

what is the normal HCO3-

A

24mM

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5
Q

what is the normal H2CO3

A

1.2mM

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6
Q

what is the ratio of HCO3 to H2CO3

A

20:1

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7
Q

pCO2 x solubility in water = what

A

moles of carbonic acid

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8
Q

what is the formula to determine moles of carbonic acid

A

pCO2 x solubility in water = moles

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9
Q

what produces bicarbonate in the body

A

kidney

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10
Q

what are the 2 ways the kidney produces bicarbonate

A

1) convert buffered acids into more acid salts
2) produce new HCO3-

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11
Q

glutamine becomes what

A

NH4 and HCO3-

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12
Q

a drop in the pH stimulates what in the lungs

A

ventilation to drop CO2

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13
Q

what is the metabolic component in acid base balances

A

HCO3-

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14
Q

what is the respiratory component in acid base balance

A

dissolved carbon dioxide

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15
Q

what is the normal range of plasma HCO3-

A

22-28mM

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16
Q

when does metabolic acidosis occur

A

under 22 mM of HCO3-

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17
Q

when does metabolic alkalosis occur

A

when plasma HCO3- is over 28 mM

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18
Q

name 3 reasons metabolic acidosis occurs

A

decreased HCO3- production (kidney)
loss of base
increase addition of fixed acid

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19
Q

what is the anion gap

A

difference between the measured cations and the measured anions in plasma

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20
Q

what is the formula for anion gap

A

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

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21
Q

what is the normal anion gap

A

6-16 mmol/L

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22
Q

what is the anion gap used to determine

A

if metabolic acidosis is due to an accumulation of non-volatile acids OR a net loss of biocarbonate

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23
Q

what are some causes of a normal anion gap metabolic acidosis

A

gut bicarbonate loss
Renal bicarb loss

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24
Q

how does the body compensate for a renal bicarbonate loss

A

rise in plasma chloride (kidneys try to reabsorb more chlorine)

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25
what is an increased anion gap metabolic acid
an addition of an acid that increase the anion gap
26
what are the 2 causes of increased anion gap metabolic acidosis
addition of acid failure of acid secretion
27
at what level of GFR does the kidney struggle to excrete H+ and retain acid anions
under 20 mL/min
28
what is the normal pCO2 and the normal range
range - 35-45 mmHg pCO2 - 40 mmHg
29
when does resp acidosis occur
PCO2 over 45 mm Hg
30
when does resp alkalosis occur
when PCO2 is under 35 mm HG
31
Pulmonary hypoventilation is a big cause of:
resp acidosis
32
what causes pulm hypoventilation
asthma rib fractures tumors emphysema edema lots of things
33
what is pulm hyperventilation caused by
anxiety salicylate ingestion extreme pain
34
at what level of pH are seizures a risk
7.8
35
what is the normal range of plasma potassium
3.5-5 mM
36
plams (K) under 3.5mM is
hypokalemia
37
plasma (K) over 5 mM is
hyperkalemia
38
what does aldosterone do with regards to sodium
activates ENaC to bring Na into the cell
39
will aldosterone be secreted for high or low potassium levels
high
40
what has the greatest effect on membrane potential
changes in ECF potassium
41
what would you see on an ECG with hyperkalemia
widened QRS peaked T wave
42
what would you see on an ECG with hypokalemia
flattened T wave U wave appears
43
what is a big heart danger with hyperkalemia
cardiac arrest
44
what is a big heart danger with hypokalemia
fatal arrythmias
45
what effect does insulin have on potassium
stimulates uptake
46
what do catecholamines do with potassium
stimulate uptake
47
what releases catecholamines
sympathetic nerves adrenal medulla
48
how do you treat hyperkalemia if K is over 6.5 and only has peaked T waves
decrease K intake remove the cause stop K-sparing diuretics
49
name 3 most serious electrical effects of hyperkalemia
sustained gradual depolarization inactivation of Na channels Renders the heart virtually unexcitable
50
name 3 ways to treat hyperkalemia if K is over 6.5 with an abnormal ECG or if K is over 8
antagonise electrical effects redistribute K Remove K from the body
51
name 3 of the most serious electrical effects of hypokalemia
sustained hyperpolarization causes full activation of Na channels Conduction abnormalities prolonged repolarization
52
what effect does sustained hyperpolarization have on QRS complex
it shortens it
53
what percent of sodium reabsorption is each part of the nephron responsible for
proximal - 65 ascending limb - 25 distal - 7 collecting duct - 3
54
what diuretic affects the ascending limb
loop
55
what diuretic affects the distal tubule
thiazides
56
what diuretic affects the collecting duct
amiloride
57
mutations in genes that code for what type of cell can cause bartters syndrome
sodium potassium chloride cotransporters
58
mutations in genes that inactivate sodium potassium chloride transporter cause what kind of syndrome
Bartters
59
Bartters syndrome affects what part of the nephron
ascending limb
60
gitelman's syndrom affects what part of the nephron
distal tubule
61
Pseudohypoaldosteronism affects what part of the neprhon
collecting duct
62
Gitelman's syndrome affects what cotransporter
Sodium chloride
63
pseudohypoaldosteronism affects what channel
ENaC
64
what ion builds up in the blood with pseudohypoaldosteronism
K
65
what is the normal sodium plasma
137-145 mmol/L
66
what happens to cells in a hypertonic ECF expansion
they shrink - water leaves cells to dilute the ECF
67
does volume of ECF in a hypotonic expansion inc or dec
increase
68
what does ADH do
acts on nephrons to stimulate water reabsorption
69
what is hyponatremia
too little sodium
70
what is the major solute in the ECF
sodium
71
what are some clinical features of hyponatremia
brain edema: lethargy confusion agitation seizures
72
what is hypovolemic hypernatremia due to
loss of water from the kidneys
73
what is isovolemic hypernatremia due to
diabetes insipidus
74
what is hypervolemic hypernatremia due to
renal retention de to hyperaldosteronism
75
what are some clinical features of hypernatremia
brain cells shrink due to water leaving: muscle twitches and seizures
76
what is diabetes insipidus
a deficient in signaling to the aquaporin channels causing lack of water retention
77
what 2 things does PTH stimulate
Ca uptake in kidneys Ca release from bones
78
what does active vitamin D stimulate
Ca uptake in intestines
79
as blood calcium levels go up, what happens to phosphate
it goes down
80
why does an increase in calcium lower phosphate levels
because it inhibits the release of PTH (which releases phosphate)
81
why does an increase in phosphate dec calcium levels
because phsophate binds to calcium reducing the amount of free calcium available
82
what are 2 main causes of hypercalcemia
hyperparathyroidism malignancy
83
what are some treatments of hypercalcemia
loop diuretics surgery to remove PT tissue if PTH is too high
84
what are some clinical features of hypercalcemia
lethargy depression kidney stones nauseau Shorter QT interval
85
name 3 causes of hypocalcemia
vit d deficiency hypoparathyroidism hyperphosphatemia
86
what are some clinical features of hypocalcemia
neuromuscular irritability muscle cramps prolonged QT interval
87
what is bone disease in CRF due to
loss of calcium phosphate from bone that cannot be replaced due to deficiency of active vit D
88
PTH (inc or dec) as GFR (inc or dec)
increases as GFR decreases
89
what is the trade off hypothesis
how PTH increases as GFR decreases
90
what are 3 treatments for bone disease in CKD
reduce phosphate intake GI phsophate binders inject active vit D

PHS 3300 (19 decks)

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