What are the renal handling of acid and bases? - reabsorbs unfiltered bicarbonate at renal corpuscle - H+ secretion in urinary buffers - reabsorbs filtered bicarbonate at renal corpuscle - H+ excretion in urinary buffers

- reabsorbs filtered bicarbonate at renal corpuscle - H+ excretion in urinary buffers

In respiratory acidosis increase in pCO2 or hypercapnia is caused by - anesthetics - inhibition of medullary respiratory center - ALS,MS - weakining of lung muscles - Airway obstruction - Cerebral disease - Respiratory depression by drugs - Neuromuscular disease

- anesthetics - inhibition of medullary respiratory center - ALS,MS - weakining of lung muscles - dec in CO2 exchange - Airway obstruction - COPD; dec in ventilation and CO2 exchange - Cerebral disease - Respiratory depression by drugs - Neuromuscular disease - Guillain-Barre syndrome

What are the buffer power determinants or efficiency of the buffer 1. amount and relative concentration of buffer components 2. absolute concentration of the buffer

1. amount and relative concentration of buffer components - a buffer is most resistatn to pH change if pH =pKa 2. absolute concentration of the buffer - less amount of buffer, less effective

Acid-Base Balance Flashcards by harryl martinez

The use of this buffer is difficult to handle logarithm without use to log tables and are cumbersome at bed side

H+
CO2+
H2O+
O+

H+

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In analyzing movements of substances across membranes, we consider _____ which are not immediately apparent from a ______

concentration difference or gradients
chemical difference or gradients
electrical gradient

difference in pH
increase in CO2 secretion
decrease Na absorption

concentration difference or gradients

difference in pH

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H+ can not be measured directly but is estimated by determining

pH
concentration gradient
CO2 secretion
Na abbsorption

determining the pH

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Haldane effect results in the combination of ______ in the lungs.

oxygen
hemoglobin
immunoglobubin

oxygen and hemoglobin

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An elevated arterial blood pH is a stimulus to _____ ventilation which acts on the central and peripheral chemoreceptors in the medulla oblongata.

increase
decrease

An elevated arterial blood pH

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Any substance that removes H ions from body fluids

Alkalai/Base

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This prevents large changes in pH of a buffer when transient accumulation of acids occur mainly from the diet

degradation of amino acid
combination of amino acid
large quantity of alkali
weak acids

degradation of amino acid

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respiratory acidos is caused by

dec in respiration
inc in arterial PCO2
inc in arterial H+ aka acidemia
inc in H and HCO3
arterial HCO3 to decrease

dec in respiration
inc in arterial PCO2
inc in H and HCO3

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The buffer system is consist of ?

weak acid

conjugate base

free protons

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(increase or decrease) During increase H ion secretion and HCO3 reabsorption

pCO2 ?
Angiotensin II ?
Aldosterone ?
H+ ?
HCO3?
ECF volume?
Potassium ?

inc
inc
inc
inc
dec
dec
dec

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What are the renal handling of acid and bases?

reabsorbs unfiltered bicarbonate at renal corpuscle
H+ secretion in urinary buffers
reabsorbs filtered bicarbonate at renal corpuscle
H+ excretion in urinary buffers

reabsorbs filtered bicarbonate at renal corpuscle
H+ excretion in urinary buffers

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2 sources of tubular non-bicarbonate buffers?

phosphate
ammonia
H2O

filtration buffer - phosphate - cannot be used in large acid loads
synthesized buffer - ammonia - large acid loads

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In respiratory acidosis increase in pCO2 or hypercapnia is caused by

anesthetics - inhibition of medullary respiratory center
ALS,MS - weakining of lung muscles
Airway obstruction
Cerebral disease
Respiratory depression by drugs
Neuromuscular disease

anesthetics - inhibition of medullary respiratory center
ALS,MS - weakining of lung muscles - dec in CO2 exchange
Airway obstruction - COPD; dec in ventilation and CO2 exchange
Cerebral disease
Respiratory depression by drugs
Neuromuscular disease - Guillain-Barre syndrome

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Haldane effect causes (oxy)hemoglobin to become stronger acid , displacing ____ in the blood to the lungs

H
O
CO2
HCO3

CO2

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MAtch problem to disease

pCO2 increases :
pCO2 decreases :
HCO3 increases :
HCO3 decreases :

respiratory acidosis
respiratory alkalosis
metabolic alkalosis
metabolic acidosis

lungs
kidney
respiratory acidosis
respiratory alkalosis
metabolic alkalosis
metabolic acidosis

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(increase or decrease) During decrease H ion secretion and HCO3 reabsorption

pCO2 ?
Angiotensin II ?
Aldosterone ?
H+ ?
HCO3?
ECF volume?
Potassium ?

dec
dec
dec
dec
inc
inc
inc

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What are the buffer power determinants or efficiency of the buffer

amount and relative concentration of buffer components
absolute concentration of the buffer

amount and relative concentration of buffer components - a buffer is most resistatn to pH change if pH =pKa
absolute concentration of the buffer - less amount of buffer, less effective

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dissociation of Hgb and O2, deoxygenated hemoglobin has ____

greater affinity for Co2 that oxygenated hemoglobin deoxygenated blood
more CO2 than oxygenated blood
carbaminohemoglobin is transported to the lungs where CO2 is released and hemoglobin can bind to O2 again

all true

dissociation of Hgb and O2, deoxygenated hemoglobin has ____

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Example of volatile acids

Sulfuric acid
H2CO3
phosphoric acid
Ketoacids
Uric Acid
Oxalic acid
Lactic Acid

H2CO3 non volatile acids/fixed acids1 -from dietary substances: meat from diet

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In fast physiochemical buffering, the bone have large buffer stores of

HCO3 and CO2
Phosphate and CO2
Phosphate and carbonate salts
HCO3 and phosphate

Phosphate and carbonate salts

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ECF - readily responds to changes of

CO2 - HCO3 buffer system
Bone matrix
Phosphate and albumin in plasma
Hgb in RBC
ICF

CO2 - HCO3 buffer system
Phosphate and albumin in plasma
Hgb in RBC

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explain metabolic acidosis overproduction or ingestion of non-volatile acids

dec in respiration
inc in arterial PCO2
inc in arterial H+ aka acidemia
inc in H and HCO3
arterial HCO3 to decrease

inc in arterial H+ aka acidemia

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What is the role of kidney in slow renal component?

a. excrete H ions
b. replenish HCO3- stores after the extra stores of ECF buffering has been depleted
c. secretes H iones
d, a and b only
e. a and c only
f. all of the above

excrete H ions replenish HCO3- stores after the extra stores of ECF buffering has been depleted

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Sulfuric acid a protein catabolism through conversion of sulfur in AA residues pair

cysteine
lysine
methionine
arginine

cysteine and methione

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\_\_\_\_\_\_ states that all work together because of pH. Change in H+ concentration in ECF balance of all buffer system changes at the same time Isohydric principle states: Henderson system Henderson-Hasselbach equation

Isohydric principle

Because pH scale is logarithmic, ____ change in pH may reflect ___ change in H+ equal unequal equal unequal

equal unequal

A type of non volatile/fixed acid that is derive from diet of fruit and vegetables Sulfuric acid H2CO3 phosphoric acid Ketoacids Uric Acid Oxalic acid Lactic Acid

phosphoric acid

Concentration of all substances in clinical medicine are expressed as unit volumes/quantities except for what ?

H+

The buffer does not eliminate added acid base but only improve the \_\_\_\_ - effect on blood pH - concentration gradient - effect of hydrolysis - pH level of buffer

blood pH

Any substance that adds H ions to body fluids

Acid

A buffer system are any substance that \_\_\_\_\_ directly binds with H+ reversibly binds with H+ directly binds with NaCl+ reversibly binds with NaCl+

reversibly binds with H+

During haldene effect, \_\_\_\_\_\_\_ of hemoglobin has a tendency to combine with CO2 Increased acidity Decreased acidity Increased alkaline Decreased alkaline

Increased acidity

Metabolic alkalosis is \_\_\_\_ inc in plasma conc of HCO3 dec in plasma conc of HCO3

inc in plasma conc of HCO3

(direct or indirect relationship? inc or dec?) Metabolic Acidosis \_\_\_plasma conc of HCO3 -\> \_\_\_filtration of HCO3 b

a. ) direct, both decreases

Removal of CO2 from the body lowers the H2CO3 and reduce the ____ shift in blood pH alkali acidic conc gradient

shift

During renal excretion of acids and bases, if all filtered bicarbonate is reabsorbed, there is \_\_\_\_ - no acid base consequences for the body - acid base consequences for the body

- no acid base consequences for the body

Match the type of metabolic acidosis to it corresponding function 1. elevated gap metabolic acidosis 2. normal gap metabolic acidosis/ hyperchlorimic metabolic acidosis Inc levels of unmeasured anion anion Cl inc to compensate for dec in HCO3 level SAG value normal inc SAG values dec SAG values

1. elevated gap metabolic acidosis - inc levels of unmeasured anion -\> inc SAG values 2. normal gap metabolic acidosis/ hyperchlorimic metabolic acidosis - anion Cl inc to compensate for dec in HCO3 level -\> SAG value normal

ECF - HCO3 and CO2 is the main chemical buffer pair - plasma proteins and inorganic phosphate During fast physiochemical buffering. In the \_\_\_\_\_, cells have large buffer stores of proteins and organic phosphate compounds ECF ICF Bone Kidney Lungs

ICF

Multiple routes for entry of acids or bases - processing of ingested foods - secretions of gastrointestinal tract - de novo generation of acids and bases from metabolism of stored fat and glycogen

- processing of ingested foods - secretions of gastrointestinal tract - de novo generation of acids and bases from metabolism of stored fat and glycogen

Match the location and compounds for fast physiochemical buffering ECF ICF BONE proteins and organic phosphate compounds Phosphate and carbonate salts plasma proteins and inorganic phosphate

ECF - plasma proteins and inorganic phosphate ICF - proteins and organic phosphate cimpounds BONE - large buffer stores of phosphate and carbonate salts

When ventilation is stimulated, the lungs blow off more CO2 making the blood more acidic less acidic more basic less basic

ventilation

Amount and relative concentrations of buffer components a buffer is most resistant to pH change if: pH = pKa pH \> pKa pH \< pKa

pH = pKa

Increase acidity of hemoglobin has a tendency to combine with CO2 and causes to \_\_\_\_\_ - release excess C - release excess H+ ions - release excess O2 - release excess CO2+ ions

- release excess H+ ions

The main chemical buffer pair in the ECF for fast physiochemical buffering HCO3 and CO2 Phosphate and CO2 Phosphate and carbonate salts HCO3 and phosphate

HCO3 and CO2

In respiratory alkalosis, PaCO2 \_\_\_\_ increase PaCO2 decrease PaCO2

decrease PaCO2

HCO3 buffers the excess H in blood causing \_\_\_ dec in respiration inc in arterial PCO2 inc in arterial H+ aka acidemia inc in H and HCO3 arterial HCO3 to decrease

arterial HCO3 to decrease

Match buffering lines of defense, their response and Mode Of Action slow renal component fast physiochemical buffering fast respiratory buffering - Buffer system response - w/n seconds - Kidneys Response - hours to days - respiratory center response - few minutes MOA - excretion of acidic or basic urine MOA - binding with H+ MOA - elimination of CO2 thru ventilation

1st: fast physiochemical buffering - buffer system response - w/n seconds MOA - binding with H+ 2nd : fast respiratory buffering - respiratory center response - few minutes MOA - elimination of CO2 thru ventilation 3rd: Slow renal component - Kidneys Response - hours to days MOA - excretion of acidic or basic urine

H+ and HCO3 transmembrane movements requires specific transporters for HCO3, it exits at the basolateral membrane via - active transport of H - Na-H antiporter NH3 - H - ATPase - Cl - HCO3 antiporters - Na - HCO3 symporters

- Cl - HCO3 antiporters - Na - HCO3 symporters

Contraction alkalosis: dec body fluid inc body fluid dec reabsorption of HCO3 inc reabsorption of HCO3 worsening of alkalosis

dec body fluid inc reabsorption of HCO3 worsening of alkalosis

(direct or indirect? inc or dec?) Renal compensation for respiratory acidosis a) \_\_NH4 secretion by PCT -\> \_\_\_NH4 excretion HCO3 added to plasma b) \_\_\_H secretion by PCT,DCT,CD (Type A cells) c) \_\_\_H-NH4 exchanger ( H + HPO4 ecretion in urine)

a) direct , both increases b) inc c) inc

In biological activity of H+ equal change in pH may reflect \_\_\_\_ - equivalent physiological effect of H+ than would equal chages in H+ - equivalent physiological effect of H+ and equal chages in H+ - no physiological effect of H+ and equal chages in H+

- equivalent physiological effect of H+ than would equal chages in H+

Occurs when metabolic alkalosis is accompanied by ECF volume contraction Chronic metabolic acidosis Chronic respiratory alkalosis Acute respiratory alkalosis Contraction alkalosis

contraction alkalosis

stimulates ventilation that primarily acts on the peripheral chemoreceptors decrease in blood pH increase in blood pH no change in blood pH

decrease in blood pH

Dog plasma in vivo Distilled water in vitro 7.44 - 7.18 7.44 - 1.89

A. Dog plasma in vivo B. Distilled water in vitro C. 7.44 - 7.18 D. 7.44 - 1.89

It is the most powerful of the acid base regulatory system fast physiochemical burring fast respiratory component slow renal component

slow renal component

Match the metabolic sources of non-volatile acids with their products / formula, some can be more than once/or multiple choices - Incomplete oxidation of carbohydrate and fat - Metabolism of phosphorous containing compounds - Oxidation of cationic acid - Oxidation of sulfur containing amino acids - Production of non-metabolizable organic acid 1. ) 2H + SO4 2. ) H3PO4 3. ) H + H2PO4 4. ) HA -\> H + A 5. ) urea(CO(NH2)2) + CO2 + H2O + H 6. ) urea(CO(NH2)2) + CO2 + H2O + H2SO4

1) oxidation of sulfur containing amino acids -\> urea + CO2 + H2O + H2SO4 -\> 2H + SO4 (methione and cysteine 2) Metabolism of phosphorous containing compounds -\> H3PO4 -\> H + H2PO4 3) Oxidation of cationic acid -\> urea + CO2 + H2O + H ( Lysine ,arginine) 4) production of non-metabolizable organic acid -\> HA -\> H + A ( uric acid, oxalic acid) 5) Incomplete oxidation of carbohydrate and fat -\> HA -\> H + A (lactic acid , ketoacids)

Part of the buffer system that less likely dissociates their ions slow release of H+ weak acid conjugate base free protons

weak acids

During renal excretion of acids and bases, when base is added to the body fluids, there is \_\_\_ - an increase in the plasma concentration of bicarbonate and excrete the same amount in the urine - an decrease in the plasma concentration of bicarbonate and excrete the same amount in the urine - an increase in the plasma concentration of bicarbonate and excrete different amount in the urine - an decrease in the plasma concentration of bicarbonate and excrete different amount in the urine

- an increase in the plasma concentration of bicarbonate and excrete the same amount in the urine

H is secreted by _________ of the collecting duct cells? HCO3 is secreted by _________ ? type A type B alpha- intercalated cells beta -intercalated cells

type A or alpha- intercalated cells type B or beta -intercalated cells

What is the respiratory compensation for metabolic alkalosis hypoventilation hyperventilation inc arterial PCO2 dec arterial PCO2 inc in H dec in H

hypoventilation -\> inc arterial PCO2 \_\> increase in H

Respiratory alkalosis dec in respiration inc in respiration dec in arterial PCO3 inc in arterial PCO3 dec in H and HCO3 inc in H and HCO3

inc in respiration -\> dec in arterial PCO3 -\> dec in H and HCO3

It is the stimuli to breath rapidly or respiratory compensation CO2 O2 H K Mg

CO2 -

The lungs regulates ___ and the kidney regulates the \_\_\_\_ HCO3 pCO2

pCO2 HCO3

Part of buffer system that has a fraction of the concentration of acid and is determined by the ratio of acid to its conjugate base weak acid conjugate base free protons

free protons

\_\_\_\_\_ is prevented by the lungs via buffering of volatile acids (CO2) acidosis alkalosis

acidosis

Where does the changes in the plasma pH leads to uptake or release of protons from RBC Bone matrix Hgb in RBC ICF ECF

ECF

Phosphoric acid is a catabolism of \_\_\_\_\_ phospholipids lipids phosphorus cationinc acids

phospholipids

Biological activity of \_\_\_ is a function of its chemical potential which is much more closely related to the logarithm of the H+. H+ O+ CO2+ pH

- H+

What are the major sources of acid

volatile acids - H2CO3 -from CO2 , end product of oxidative metabolism non volatile acids/fixed acids - from dietary substances: meat from diet - sulfuric acid sulfur in AA residues cysteine and methionine - phosphoric acid - catabolism of phopholipids - fruit and vegetables What are the major sources of acid

Which is true about SAG - serum anion gap - represents the measured anions in serum - Na - ( CO2 + HCO3-) - Anions: phosphate, sulfate, citrate and protein - Normal values 14 mEq/L (10 - 18 mEq/L)

- Anions phosphate, sulfate, citrate and protein - represents the unmeasured anions in serum - Na+ -( Cl- + HCO3-) - Anions phosphate, sulfate, citrate and protein - Normal values 12 mEq/L (8 - 16 mEq/L)

Metabolic alkalosis: loss of non volatile H or gain in base gain of non volatile H or gain in acid dec in arterial H or alkalemia inc in arterial H or alkalemia arterial HCO3 decreases arterial HCO3 increases

loss of non volatile H or gain in base -\> dec in arterial H or alkalemia -\> arterial HCO3 increases

Match the metabolic sources of non-volatile acids with their products / example - Incomplete oxidation of carbohydrate and fat - Metabolism of phosphorous containing compounds - Oxidation of cationic acid - Oxidation of sulfur containing amino acids - Production of non-metabolizable organic acid 1. ) methione and cysteine 2. ) H3PO4 3. ) Lysine and arginine 4. ) uric acid, oxalic acid 5) lactic acid and ketoacids

1. oxidation of sulfur containing amino acids -\> urea + CO2 + H2O _ H2SO4 -\> 2H + SO4 (methione and cysteine 2.) Metabolism of phosphorous containing compounds -\> H3PO4 -\> H + H2PO4 3.)Oxidation of cationic acid -\> urea + CO2 + H2O + H ( Lysine ,arginine) 4.) production of non-metabolizable organic acid -\> HA -\> H + A ( uric acid, oxalic acid) 5) Incomplete oxidation of carbohydrate and fat -\> HA -\> H + A (lactic acid , ketoacids)

Used to quantitate on how changes in CO2 and HCO3 affects pH Isohydric principle states: Henderson system Henderson-Hasselbach equation

Henderson-Hasselbach Equation pH = PK1 + log(HCO3/H2CO3)

Fixed acids from diet of fruit and vegetables leads to a net production of non volatile constituents consist of \_\_\_\_\_ alkali acid H3PO4 H2O

alkali

H+ and HCO3 transmembrane movements requires specific transporters for H - active transport of H - Na-H antiporter NH3 - H - ATPase HCO3 - Cl - HCO3 antiporters - Na - HCO3 symporters

- active transport of H - cells to lumen - Na-H antiporter NH3 - major transporter - H - ATPase HCO3

Fast physiochemical buffering location where cells have large buffer stores ECF ICF Bone

ECF - HCO3 and CO2 is the main chemical buffer pair - plasma proteins and inorganic phosphate ICF - cells have large buffer stores - proteins and organic phosphate cimpounds -HCO3 , lower conc than ECF BONE - large buffer stores of phosphate and carbonate salts

volatile acids like H2CO3 is an end product of oxidative metabolism from \_\_\_\_ H O CO2 HCO3

CO2

Renal compensation has occured, blood pH decrease towards normal Chronic metabolic acidosis Chronic respiratory alkalosis Acute respiratory alkalosis Contraction alkalosis

What is the respiratory exchange ratio? 0. 5 (50 CO2 to 100 O2) 0. 6 (60 CO2 to 100 O2) 0. 7 (70 CO2 to 100 O2) 0. 8 (80 CO2 to 100 O2) 0. 9 (90 CO2 to 100 O2)

0.8 (80 CO2 to 100 O2)

Renal compensation has not yet occured? Chronic metabolic acidosis Chronic respiratory alkalosis Acute respiratory alkalosis Contraction alkalosis

acute resp. alk. - renal compensation has not yet occured chronic resp. alk. = renal compensation has occured, blood pH decrease towards normal

Range of plasma pH that is compatible with life? Normal pH of extracellular fluid (ECF) is maintained between?

6.8 - 7.8 7.35 - 7.45

adaptive increase in ammonia (NH3) synthesis to help excrete excess H+ Chronic metabolic acidosis Chronic respiratory alkalosis Acute respiratory alkalosis Contraction alkalosis

Chronic metabolic acidosis