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Physiology HM > Acid-Base Balance > Flashcards

Acid-Base Balance Flashcards

1
Q

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+

A

H+

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2
Q

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

A

concentration difference or gradients

difference in pH

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3
Q

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

pH
concentration gradient
CO2 secretion
Na abbsorption

A

determining the pH

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4
Q

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

oxygen
hemoglobin
immunoglobubin

A
  • oxygen and hemoglobin
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5
Q

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

increase
decrease

A

An elevated arterial blood pH

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6
Q

Any substance that removes H ions from body fluids

A

Alkalai/Base

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7
Q

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

A

degradation of amino acid

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8
Q

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

A

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

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9
Q

The buffer system is consist of ?

A

weak acid

conjugate base

free protons

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10
Q

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

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

A

inc
inc
inc
inc
dec
dec
dec

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11
Q

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
A
  • reabsorbs filtered bicarbonate at renal corpuscle
  • H+ excretion in urinary buffers
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12
Q

2 sources of tubular non-bicarbonate buffers?

phosphate
ammonia
H2O

A
  • filtration buffer - phosphate - cannot be used in large acid loads
  • synthesized buffer - ammonia - large acid loads
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13
Q

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
A
  • 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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14
Q

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

H
O
CO2
HCO3

A

CO2

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15
Q

MAtch problem to disease

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

respiratory acidosis
respiratory alkalosis
metabolic alkalosis
metabolic acidosis

A

lungs
kidney
respiratory acidosis
respiratory alkalosis
metabolic alkalosis
metabolic acidosis

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16
Q

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

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

A

dec
dec
dec
dec
inc
inc
inc

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17
Q

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
A
  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
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18
Q

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

A

all true

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

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19
Q

Example of volatile acids

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

A

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

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20
Q

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

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

A

Phosphate and carbonate salts

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21
Q

ECF - readily responds to changes of

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

A

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

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22
Q

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

A

inc in arterial H+ aka acidemia

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23
Q

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

A

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

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24
Q

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

cysteine
lysine
methionine
arginine

A

cysteine and methione

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25
Q

______ 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

A

Isohydric principle

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26
Q

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

equal
unequal

equal
unequal

A

equal

unequal

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27
Q

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

A

phosphoric acid

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28
Q

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

A

H+

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29
Q

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
A

blood pH

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30
Q

Any substance that adds H ions to body fluids

A

Acid

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31
Q

A buffer system are any substance that _____

directly binds with H+
reversibly binds with H+
directly binds with NaCl+
reversibly binds with NaCl+

A

reversibly binds with H+

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32
Q

During haldene effect, _______ of hemoglobin has a tendency to combine with CO2

Increased acidity
Decreased acidity
Increased alkaline
Decreased alkaline

A

Increased acidity

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33
Q

Metabolic alkalosis is ____

inc in plasma conc of HCO3
dec in plasma conc of HCO3

A

inc in plasma conc of HCO3

34
Q

(direct or indirect relationship? inc or dec?) Metabolic Acidosis

___plasma conc of HCO3 -> ___filtration of HCO3 b

A

a. ) direct, both decreases

35
Q

Removal of CO2 from the body lowers the H2CO3 and reduce the ____ shift in blood pH

alkali
acidic
conc gradient

A

shift

36
Q

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
A
  • no acid base consequences for the body
37
Q

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

A
  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
38
Q

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

A

ICF

39
Q

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
A
  • processing of ingested foods - secretions of gastrointestinal tract - de novo generation of acids and bases from metabolism of stored fat and glycogen
40
Q

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

A

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

41
Q

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

more acidic
less acidic
more basic
less basic

A

ventilation

42
Q

Amount and relative concentrations of buffer components a buffer is most resistant to pH change if:

pH = pKa
pH > pKa
pH < pKa

A

pH = pKa

43
Q

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
A
  • release excess H+ ions
44
Q

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

A

HCO3 and CO2

45
Q

In respiratory alkalosis, PaCO2 ____

increase PaCO2
decrease PaCO2

A

decrease PaCO2

46
Q

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

A

arterial HCO3 to decrease

47
Q

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

A

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

48
Q

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
A
  • Cl - HCO3 antiporters
  • Na - HCO3 symporters
49
Q

Contraction alkalosis:

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

A

dec body fluid
inc reabsorption of HCO3
worsening of alkalosis

50
Q

(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

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

51
Q

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+
A
  • equivalent physiological effect of H+ than would equal chages in H+
52
Q

Occurs when metabolic alkalosis is accompanied by ECF volume contraction

Chronic metabolic acidosis
Chronic respiratory alkalosis
Acute respiratory alkalosis
Contraction alkalosis

A

contraction alkalosis

53
Q

stimulates ventilation that primarily acts on the peripheral chemoreceptors

decrease in blood pH
increase in blood pH
no change in blood pH

A

decrease in blood pH

54
Q

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

A

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

55
Q

It is the most powerful of the acid base regulatory system

fast physiochemical burring
fast respiratory component
slow renal component

A

slow renal component

56
Q

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
A

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)

57
Q

Part of the buffer system that less likely dissociates their ions slow release of H+

weak acid
conjugate base
free protons

A

weak acids

58
Q

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
A
  • an increase in the plasma concentration of bicarbonate and excrete the same amount in the urine
59
Q

H is secreted by _________ of the collecting duct cells?

HCO3 is secreted by _________ ?

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

A

type A or alpha- intercalated cells

type B or beta -intercalated cells

60
Q

What is the respiratory compensation for metabolic alkalosis

hypoventilation
hyperventilation
inc arterial PCO2
dec arterial PCO2
inc in H
dec in H

A

hypoventilation -> inc arterial PCO2 _> increase in H

61
Q

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

A

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

62
Q

It is the stimuli to breath rapidly or respiratory compensation

CO2
O2
H
K
Mg

A

CO2 -

63
Q

The lungs regulates ___ and the kidney regulates the ____

HCO3
pCO2

A

pCO2
HCO3

64
Q

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

A

free protons

65
Q

_____ is prevented by the lungs via buffering of volatile acids (CO2)

acidosis
alkalosis

A

acidosis

66
Q

Where does the changes in the plasma pH leads to uptake or release of protons from RBC

Bone matrix
Hgb in RBC
ICF
ECF

A

ECF

67
Q

Phosphoric acid is a catabolism of _____

phospholipids
lipids
phosphorus
cationinc acids

A

phospholipids

68
Q

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

A
  • H+
69
Q

What are the major sources of acid

A

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
70
Q

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)
A
  • 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)
71
Q

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

A

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

72
Q

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
A
  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)
73
Q

Used to quantitate on how changes in CO2 and HCO3 affects pH

Isohydric principle states:
Henderson system
Henderson-Hasselbach equation

A

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

74
Q

Fixed acids from diet of fruit and vegetables leads to a net production of non volatile constituents consist of _____

alkali
acid
H3PO4
H2O

A

alkali

75
Q

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
A
  • active transport of H - cells to lumen
  • Na-H antiporter NH3 - major transporter
  • H - ATPase HCO3
76
Q

Fast physiochemical buffering location where cells have large buffer stores

ECF
ICF
Bone

A

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

77
Q

volatile acids like H2CO3 is an end product of oxidative metabolism from ____

H
O
CO2
HCO3

A

CO2

78
Q

Renal compensation has occured, blood pH decrease towards normal

Chronic metabolic acidosis
Chronic respiratory alkalosis
Acute respiratory alkalosis
Contraction alkalosis

A
79
Q

What is the respiratory exchange ratio?

  1. 5 (50 CO2 to 100 O2)
  2. 6 (60 CO2 to 100 O2)
  3. 7 (70 CO2 to 100 O2)
  4. 8 (80 CO2 to 100 O2)
  5. 9 (90 CO2 to 100 O2)
A

0.8 (80 CO2 to 100 O2)

80
Q

Renal compensation has not yet occured?

Chronic metabolic acidosis
Chronic respiratory alkalosis
Acute respiratory alkalosis
Contraction alkalosis

A

acute resp. alk. - renal compensation has not yet occured

chronic resp. alk. = renal compensation has occured, blood pH decrease towards normal

81
Q

Range of plasma pH that is compatible with life?

Normal pH of extracellular fluid (ECF) is maintained between?

A

6.8 - 7.8 7.35 - 7.45

82
Q

adaptive increase in ammonia (NH3) synthesis to help excrete excess H+

Chronic metabolic acidosis
Chronic respiratory alkalosis
Acute respiratory alkalosis
Contraction alkalosis

A

Chronic metabolic acidosis

Physiology HM (5 decks)

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