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RUSVM Physiology II > Acid Base Balance > Flashcards

Acid Base Balance Flashcards

1
Q

A substance in the body that helps maintain physiological pH (abut 7.4)

A

Buffer

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2
Q

What two organs help maintain physiological pH?

A

Lungs and kidneys

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3
Q

What is pH?

A

Measure of the proton concentration in a solution

pH and H+ concentration is inversely related

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4
Q

What is the Henderson Hasselbach equation?

A

.pH=pKa+ log[base]/[acid]

.pH= pKa+ log [HCO3-]/[0.003 x pCO2]

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5
Q

What is the dissociation constant for bicarbonate buffer?

A

PKa= 6.1

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6
Q

An increase in HCO3- concentration will __________ pH

A

Increase -> alkalosis

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7
Q

An increase in PCO2 will ____________ pH

A

Decrease -> acidosis

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8
Q

A molecule that can release(donate) H+ ions

A

Acid

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9
Q

Acids that are generated as by products of metabolism are called ?

A

Non-volatile acids

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10
Q

An acid that is generated by a hydration reaction (eg carbonic acid) is called?

A

Volatile acid

H2O + CO2 -> H2CO3

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11
Q

An acid that rapidly dissociates and releases high amounts of H+

A

Strong acid

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12
Q

A base that binds rapidly and strongly with H+ and removes it from solution

A

Strong base

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13
Q

Most acids and bases present in the ECF behave as (strong/weak) acids and bases

A

Weak

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14
Q

A molecule formed by the combination of one or more of the alkaline metals with a basic ion (OH-)

A

Alkali

base=alkali

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15
Q

What is the normal range of pH?

A

7.35- 7.45

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16
Q

A depression of pH below the normal range is ________

A

Acidemia

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17
Q

An elevation of pH above the normal range

A

Alkalemia

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18
Q

A condition cause by the addition of excess acid or removal of base from the ECF

A

Acidosis

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19
Q

A condition caused by the addition of excess base or the removal of acid from the ECF

A

Alkalosis

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20
Q

What are the three buffer systems?

A

Bicarbonate
Phosphate
Proteins

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21
Q

What three systems regulate pH in the body?

A

Buffer
Respiration
Kidney

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22
Q

What is the most important extracellular buffer?

A

Bicarbonate

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23
Q

What makes bicarbonate the most important buffer system?

A

Open system -modify CO2 (lungs) or HCO3- (kidney)

Abundant

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24
Q

If the concentration of H+ increases, how does the bicarbonate buffer compensate?

A

excess H+ combines with HCO3 -> H2CO3 -> increase CO2

Excess CO2 is eliminated with he lungs

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25
Q

If the concentration of H+/HCO3- decreases, how does the bicarbonate buffer system compensate?

A

H2CO3 dissociates to form more H+ and HCO3-

CO2 and H2O hydrolysis to form H2CO3

CO2 levels decrease and respiration is decreased

26
Q

The phosphate buffer is important (extracellularly/intracellularly)?

A

Intracellular

27
Q

How does the phosphate buffer maintain pH?

A

HPO4 combines with H+ (base) to increase pH

Eg HCl + HPO4 -> H2PO4 + Cl-

28
Q

How do proteins buffer pH and where are they important?

A

Important buffers in both intracellular and extracellular compartments

Contains large number of basic amino acids that bind H+

29
Q

Hemoglobin is a_____________ buffer that binds H+ on __________________

A

Protein; histidine (imidazole) or carboxyl groups

30
Q

What are the intracellular buffers?

A

Amino acids, protein, phosphate

31
Q

What buffers are important in interstitial fluid?

A

Bicarbonate, phosphate, protein

32
Q

What buffer system is important in CSF?

A

Bicarbonate

33
Q

What are the important buffer systems in plasma?

A

Bicarbonate, protein, phosphate

34
Q

How does an increase in ventilation change pH?

A

Increase ventilation -> CO2 elimination -> decrease H+ concentration -> increase pH

35
Q

How does a decrease in ventilation change pH?

A

Decrease ventilation -> CO2 accumulation in body-> increase H+ -> decrease pH

36
Q

An impaired lung function can cause ____________ because of the accumulation of CO2 in the body

A

Acidosis

37
Q

If H+ excretion > HCO3- excretion the urine is _______

A

Acidic

38
Q

Where is HCO3- reabsorbed in the kidney?

A

PT, TAL, DT and CD

39
Q

H+ is secreted in what parts of they kidney?

A

PT, TAL, DT, and CD

40
Q

What carriers are involved in H+ secretion in the PT, TAL, and DT? Is it located apically or basolaterally?

A

Na/H+ antiport
H+ ATPase

Apical

41
Q

What carriers are required for HCO3- reabsorption? And where are these carriers located?

A

HCO3/Na cotransporter
HCO3/Cl antiporter

Basolateral membrane

42
Q

During acidosis, how does the kidney compensate to maintain pH?

A

High H+ concentration promotes complete reabsorption of HCO3- and the excess H+ will be eliminated in urine

43
Q

In alkalosis, how does the kidney aid in maintaining pH?

A

Excess HCO3 cannot combine with H+ and is not reabsorbed -> excreted in the urine

44
Q

In the late DT and Cd, Type A cells secrete __________ and type B cells secrete _________

A

Acid; bicarbonate

45
Q

Type A cells have H+ ATPase and H+/K+ ATPase located __________, and an HCO3-/Cl antiporter located ________?

A

Apically; basolaterally

Type B cells are flipped

46
Q

Most H+ in the tubular lumen is excreted as?

A

Ammonia

47
Q

How does an intercalated cells change its morphology in response to and acid-base imbalance ?

A

Cell actively secreting protons -> increase carriers and SA on apical membrane

Fewer vesicles seen -> fused with he apical membrane

48
Q

What is the anion gap?

A

Difference between unmeasured cations and unmeasured anions

[Na+] - [HCO3- + Cl-] = (range 8-16mEq/L)

49
Q

If unmeasured anions rise or if unmeasured cations fall what happens to the anion gap?

A

Anion gap increased

50
Q

What four parameters are required for analyzing acid-base balance status?

A

.pH of blood
.pCO2
Standard bicarbonate
Base excess

51
Q

An pH <7.4 with elevated pCO2 is a _____________________ that requires what type of compensation?

A

Respiratory acidosis; renal compensation (increase HCO3-)

52
Q

A pH <7.4 with decreased HCO3- levels is a ________________ that requires what type of compensation?

A

Metabolic acidosis; respiratory compensation (decrease CO2)

53
Q

A pH >7.4 with high HCO3- levels is a __________________ that requires what kind of compensation?

A

Metabolic alkalosis; respiratory compensation (increase CO2)

54
Q

A pH > 7.4 is a with low levels of pCO2 is a _______________ which requires what type of compensation?

A

Respiratory alkalosis; renal compensation (decrease HCO3-)

55
Q

Increasing altitude has what affect on physiological pH and how is it compensated?

A

Low pO2 at high altitude -> increase ventilation and exhaled CO2 -> decreased pCO2 =>respiratory alkalosis

Compensate by renal excretion of HCO3-

56
Q

What common disorders cause respiratory alkalosis?

A

Alveolar hyperventilation during anesthesia
High altitude
Damage to respiratory centers
Emotional excitement

57
Q

What common disorders cause respiratory acidosis?

A

Alveolar hypoventilation
Fractured ribs
Bloated abdomens
Respiratory obstructive disease

58
Q

What common disorders leads to metabolic acidosis ?

A 
Renal failure
Hyperkalemia
Hyperparathyroidism 
Diarrhea (eliminating HCO3)
Fistula
Mineralization of bone (requires HCO3) 
Lactate formation (acid formation) 
Satarvation 
Diabetes mellitus (acid ketone bodies) 
Increased fat mobilization 
Protein rich diet
Rumen acidosis
59
Q

What disorders lead to metabolic alkalosis?

A

Vomiting - loss of HCl
Torsion of abomasum- HCl trapped; reduce acid in the rest of body
Hypokalemia
Hypoparathyroidism

60
Q

How does acid-base balance alter K+ concentration?

A

H+ elimination is accompanied by K+ reabsorption

acidosis -> high H+ eliminated -> increased K+ reabsorption -> hyperkalemia

Alkalosis -> H+ reabsorbed -> K+ secreted -> hypokalemia

RUSVM Physiology II (11 decks)

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