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Renal > Acid Base Balance > Flashcards

Acid Base Balance Flashcards

1
Q

What is the normal pH of arterialised blood

A

7.4

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2
Q

What are the sources of H+ in the body?

A

Respiratory acid

Metabolic acids

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3
Q

What are some examples of inorganic acids within the body?

A

S-containing amino acids

Phospholipids

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4
Q

What are some examples of organic acids within the body?

A

Fatty acids

Lactic acids

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5
Q

What is a major source of alkali in the body?

A

Oxidation of organic anions e.g citrate

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6
Q

What is the role of buffers in the body?

A

Minimize changes in pH when H+ ions are added or removed

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7
Q

What is the Henderson-Hasselbalch equation?

A

Defines the pH in terms of the ration of base/acid (A-/HA) NOT the absolute amounts

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8
Q

What is the most important extracellular buffer?

A

Bicarbonate buffer

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9
Q

What is the normal range of pH in the body?

A

7.37-7.43

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10
Q

What is the pH range compatible with life?

A
  1. 0-7.6 (UK)

6. 8-7.8 (US)

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11
Q

What is the normal value of pCO2 in the body?

A

5.3kPa (40mmHg)

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12
Q

What is the normal range of pCO2 in the body?

A

4.8-5.9 (36-44mmHg)

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13
Q

What is the normal value of HCO3- in the body?

A

24mmoles/L

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14
Q

What is the normal range of HCO3- in the body?

A

22-26

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15
Q

How is H+ eliminated from the body?

A

Kidneys

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16
Q

What are some other buffers in the ECF?

A 
Plasma proteins (Pr- + H+  HPr 
Dibasic phosphate (HPO42- + H+  H2PO4)
17
Q

What are some the intracellular buffers?

A

Proteins
Organic and inorganic phosphates
Haemoglobin

18
Q

What is the main effect of buffering H+ ions by ICF buffers?

A

Changes in plasma electrolytes

19
Q

What is the effect of an increase in H+ in acidosis?

A

Hyperkalaemia. depolarisation of excitable tissues, ventricular fibrillation and death

20
Q

How do the kidneys regulate HCO3-?

A

Reabsorbing filtered HCO3-

Generating new HCO3-

21
Q

What is kidney regulation of HCO3- dependent on?

A

Active H+ ion secretion from the tubule cells into the lumen

22
Q

What is the mechanism for the reabsorption of HCO3- by the kidneys?

A

Active H+ secretion from the tubule cells
Coupled to passive Na+ reabsorption
Filtered HCO3- reacts with secreted H+
Changes into CO2 and H2O in the presence of carbonic anhydrase on the luminal membrane
CO2 freely permeable, enters cell
Dissociates into H+ and HCO3-
HCO3- pass into peritubular capillaries with Na+

23
Q

Where in the kidneys does HCO3- reabsorption occur?

A

Proximal tubule

24
Q

What are the pH limits of urine in humans?

A

4.5-5 (min)

8 (max)

25
Q

What is titratable acidity?

A

Several weak acids and bases act as buffers

26
Q

Where does titratable acidity principally occur?

A

Distal tubule

27
Q

What is titratable acidity dependent on?

A

PCO2 of the blood

28
Q

What is ammonium excretion a response to?

A

Major adaptive response to an acid load, generates new HCO3- and excretes H+

29
Q

What does respiratory acidosis result from?

A

Reduced ventilation, retention of CO2

30
Q

What are the acute causes of respiratory acidosis?

A

Drugs which depress the medullary respiratory centres (barbiturates, opiates)
Obstructions of major airways

31
Q

What are the chronic causes of respiratory acidosis?

A

Lung disease (Bronchitis, emphysema, asthma)

32
Q

What is the response to respiratory acidosis?

A

Protect pH so increase HCO3-

33
Q

What does respiratory alkalosis result from?

A

Fall in pCO2, increased ventilation and CO2 blow off

34
Q

What are the acute causes of respiratory alkalosis?

A

Voluntary hyperventilation
Aspirin
First ascent to altitude

35
Q

What are the chronic causes of respiratory alkalosis?

A

Long term residence at altitude

36
Q

What is the response to respiratory alkalosis?

A

Protect pH so decrease HCO3-

37
Q

What does metabolic acidosis result from?

A

Decrease HCO3- from increased buffering of H+ or direct loss of HCO3-

38
Q

What are the causes of metabolic acidosis?

A

Increased H+ production (ketoacidosis of a diabetic)
Failure to excrete normal dietary load of H+ as in renal failure
Loss of HCO3- as in diarrhoea

Renal (24 decks)

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