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Western Medicine 502 > Acid-Base Balance > Flashcards

Acid-Base Balance Flashcards

1
Q

The greatest percentage of the body’s water is in

A

the intracellular fluid

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2
Q

Hypertension is likely to increase the secretion of

A

atrial natriuretic peptide

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3
Q

______ increases water reabsorption without increasing sodium reabsorption.

A

Antidiuretic hormone

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4
Q

Hypotonic hydration can result from

A

ADH hypersecretion

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5
Q

Tetanus is most likely a result from

A

hypocalcemia

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6
Q

The principle determinant of intracellular osmolarity and cellular volume is

A

potassium

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7
Q

Increased excretion of ammonium chloride in the urine most likely indicates

A

hypercalcemia

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8
Q

The most effective buffer in the intracellular fluid is

A

protein

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9
Q

Tubular secretion of hydrogen is directly linked to

A

tubular reabsorption of sodium

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10
Q

The most abundant cation in the ECF is

A

Na+

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11
Q

The most abundant cation in the ICF is

A

K+

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12
Q

The skin loses water by two processes, sweating and ____

A

cutaneous transport

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13
Q

Water produced by the body’s chemical reactions is called _____

A

metabolic water

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14
Q

An excessive concentration of potassium ions in the blood is called _____

A

hyperkalemia

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15
Q

A deficiency of sodium ions in the blood is called ______

A

hyponatremia

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16
Q

A blood pH of 7.2 caused by inadequate pulmonary ventilation would be classified as _____

A

respiratory acidosis

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17
Q

Long-term satiation of thirst depends on a reduction of the _____ of the blood.

A

osmolarity

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18
Q

The 3 types of homeostatic balance

A

water balance
electrolyte balance (electrolytes absorbed in SI balance that lost in urine)
acid-base balance (body rids itself of acid/H+ at rate that balances metabolic production)

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19
Q

Bodily water gains come from these 2 sources

A 
Preformed water (2,300 mL/day) from ingested food and drink (1600 mL/day)
metabolic water (200 mL/day) as a by-product of aerobic metabolism and dehydration synthesis
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20
Q

The major fluid compartments of the body

A

65% intracellular fluid (ICF)

35% extracellular fluid (ECF)

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21
Q

Water moves by _____ from one fluid compartment to another, and is determined by the relative _____ of solutes in each compartment. _____ are the most abundant solutes particles and play the principle role in governing the body’s water distribution and total water content.

A

osmosis, concentrations, electrolytes

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22
Q

In edema, fluid accumulates within the _____ compartments. It is associated with diseases of the heart, liver and kidneys and is a form of _____-retention imbalance.

A

Interstitial, salt

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23
Q

Dehydration reduces blood volume and blood pressure and increases blood _____.

A

osmolarity

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24
Q

The rise in the osmolarity of the _____ is associated with the drop in blood volume. When blood pressure drops, the _____ produces an antidiuretic hormone to promote water conservation. The _____ _____ _____ system becomes activated, and the _____ produces a conscious sense of thirst.

A

ECF, hypothalamus, renin-angiotensin-aldosterone, cortex

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25
Q

_____ secretion is stimulated by hypothalamic osmoreceptors in response to dehydration. This gives rise to a decrease in water volume and increased osmolarity, which concentrates _____. _____ release is inhibited when blood volume and blood pressure is too high or blood osmolarity is too low. This is an effective way to compensate for _____.

A

ADH, urine, ADH, hypertension

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26
Q

Fluid imbalance refers to these 3 kinds of abnormalities

A
  • Total volume
  • concentration
  • distribution of fluid among the compartments
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27
Q

2 main factors in fluid deficiency

A

hypovolemia (volume depletion)

dehydration (negative water balance)

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28
Q

In hypovolemia, total body _____ declines, but _____ remains normal. Can occur from hemorrage, severe burns, chronic vomiting, or diarrhea.

A

water, osmolarity

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29
Q

In dehydration, the body eliminates significantly more _____ than _____. The total body _____ declines, and _____ rises. It can result from insufficient water intake, diabetes, ADH hyposecretion (diabetes insipidus), profuse sweating, or overuse of diuretics. Infants are more volunerable to dehydration due to high _____ rate that demands high urine excretion.

A

water, sodium, water, osmolarity, metabolic

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30
Q

The body conserves heat by _____ blood vessels of the skin and forcing blood to deeper circulation. This raises blood pressure which inhibits the secretion of _____. It also increases secretion of _____ _____ _____. Urine output is _____ and blood volume _____.

A

constricting, ADH, atrial natriuretic peptide, increased, reduced

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31
Q

Cold air is drier and increases _____ water loss, also reducing blood volume. Cold weather respiratory and urinary water losses cause a state of _____.

A

respiratory, hypovolemia

32
Q

Exercise dilates vessels in _____ muscles. Insufficient blood for the rest of the body can bring on weakness, fatigue, or fainting (_____ shock)

A

skeletal, hypovolemic

33
Q

In excessive sweating, the blood absorbs tissue fluid (300 mL) to replace volume loss. Tissue fluid is pulled from _____ (700 mL).

A

ICF

34
Q

dehydration, excessive sweating, rapid heart beat, dizziness, fatigue, and muscle cramps are signs of heat _____ which, if untreated, can lead to heat _____

A

exhaustion, stroke

35
Q

Fluid excess is less common than fluid deficiency because the _____ are highly effective in compensating for excessive intake by excreting more urine. _____ failure can lead to fluid retention

A

kidneys, renal

36
Q

2 types of fluid excess

A
  • volume excess

- hypotonic hydration (water intoxication) (positive water balance)

37
Q

In volume excess, both _____ and _____ are retained and the ECF remains _____. It can be caused by _____ hypersecretion or renal failure.

A

Na+, water, isotonic, aldosterone

38
Q

In hypotonic hydration, more _____ than _____ is retained or ingested and the ECF becomes _____. This can cause cellular swelling and pulmonary and cerebral edema.

A

water, Na+, hypotonic

39
Q

Electrolytes are chemically reactive and participate in _____. They determine _____ potential across membranes. They strongly affect the _____ of body fluids, and affect the body’s water _____ and _____.

A

metabolism, electrical, osmolarity, content, distribution

40
Q

major cations

A

Na+ (sodium)
K+ (potassium)
Ca2+ (calmodulin-dependent protein kinases II or CaM kinases II)
H+ (positively charged hydrogen ions)

41
Q

_____ is the principle ion responsible for the resting membrane potentials. Inflow of _____ through membrane gates is an essential event in the depolarization that underlies nerve and muscle function.

A

sodium, sodium

42
Q

Sodium is the principle cation in _____. It accounts for 90-95% of it’s _____. It is the most significant solute in determining total body _____ and distribution of _____ among the fluid compartments

A

ECF, osmolarity, water, water

43
Q

The average adult needs ___ g of sodium per day. The typical american diet contains _____ g per day.

A

0.5, 3-7

44
Q

Sodium concentration is coordinated by _____, the “salt retaining hormone” which raises blood pressure. It has a primary role in adjusting sodium _____. Its primary effects are that the urine contains less _____ and more _____ and has a lower _____.

A

aldosterone, excretion, NaCl (sodium chloride), potassium, pH

45
Q

_____ is when the plasma sodium concentration is greater than 145 mEq/L. It can be caused by administration if IV saline and can result in water pretension, hypertension and edema.

A

hypernatremia

46
Q

hyponatremia is when the plasma sodium concentration is less than ___ mEq/L. It can occur when a person loses large volumes of water via sweat or urine and replaces it with plain drinking water.

A

130

47
Q

_____ is the most abundant cation of ICF and is the greatest determinant of its osmolarity and cell volume.

A

potassium

48
Q

90% of K+ in glomerular filtrate is reabsorbed by the _____. _____ stimulates the renal secretion of K+.

A

PCT, aldosterone

49
Q

_____ imbalances are the most dangerous imbalances of electrolytes.

A

potassium

50
Q

The effects of _____ depend on whether the potassium concentration rises quickly or slowly. A concentration greater than 5.5 mEg/L can produce _____ _____.

A

hyperkalemia, cardiac arrest

51
Q

_____ is a potassium concentrates less than 3.5 mEq/L. It rarely results from _____ deficiency, and more often from sweating, chronic vomiting or diarrhea. _____ and _____ cells become less excitable resulting in muscle weakness and loss of muscle tone, decrease reflexes, and arrhythmia from irregular electrical activity in the heart.

A

hypokalemia, dietary, nerve, muscle

52
Q

Calcium lends strength to the _____;
activates the _____ _____ mechanism of muscle contraction; serves as a second _____ for some hormones and neurotransmitters; activates _____ of neurotransmitters and other cellular secretions; and is an essential factor in _____ _____

A

bones, sliding filament, messenger, exocytosis, blood clotting

53
Q

_____ is calcium concentrations greater than 5.8 mEq/L. It can result in alkalosis, hyperparathyroidism, and hypothyroidism. Concentrations greater than 12 mEq/L causes muscular weakness, depressed reflexes, and cardiac arrhythmia.

A

hypercalcemia

54
Q

_____ is calcium concentrations less than 4.5 mEq/L. It can result from vit. D deficiency, diarrhea, pregnancy, acidosis, lactation, hypoparahtyroidism, and hyperthyroidism. It increases membrane Na+ permeability, causing nervous and muscular systems to be abnormally excitable. Very low levels can result in tetanus, laryngospasm and death

A

hypocalcemia

55
Q

Acid-base balance is one of the most important aspects of _____. _____ depends on enzymes, and enzymes are sensitive to pH. A slight deviation from the normal pH can shut down entire _____ pathways and alter the structure and function of _____. ___ to ___ is the normal pH range of blood and tissue fluid.

A

homeostasis, metabolism, metabolic, macromolecules, 7.35, 7.45

56
Q

Challenges to acid-base balance result from _____ constantly producing acid: _____ acid from anaerobic fermentation, _____ acid from nucleic acid catabolism, _____ acids and _____ from fat catabolism, and _____ acid from carbon dioxide.

A

metabolism, lactic, phosphoric, fatty, ketones, carbonic

57
Q

Metabolic _____ is when the pH is less than 7.35, and metabolic _____ is when the pH is greater than 7.45.

A

Acidosis, alkylosis

58
Q

The pH of a solution is determine solely by its _____ _____.

A

hydrogen ions

59
Q

Acids are chemicals that _____ H+ in solutions. _____ acids like HCl ionize freely, giving up most of its H+ and markedly lower the pH of a solution. _____ acids like carbonic acid (H2CO3) ionize only slightly, keeping most H+ chemically bound and not affecting pH.

A

release, strong, weak

60
Q

Bases are chemicals that _____ H+. _____ bases like hydroxide ions (OH-) have a strong tendency to bind H+ and markedly raise pH. _____ bases such as the bicarbonate ion (HCO3-) bind less available H+ and has less of an effect on pH.

A

accept, strong, weak

61
Q

A _____ is any mechanism that resists changes in pH by converting strong acids or bases to weak ones.

A

buffer

62
Q

The urinary and respiratory systems are _____ buffers. The _____ system cannot alter pH as much as the _____ system.

A

physiological, respiratory, urinary

63
Q

The 3 major chemical buffers

A

bicarbonate
phosphate
protein systems

64
Q

The _____ buffer system account for about 3/4 of all chemical buffering in the body fluids. Its ability is due to certain side groups of their _____ _____ residues. These include _____ side groups which release H+ when pH begins to rise, and _____ side groups that bind H+ when pH gets too low.

A

protein, amino acid, carboxyl (-COOH), amino (-NH2)

65
Q

The _____ buffer system functions bes in the lungs and kidneys to constantly remove CO2. To lower pH, the kidneys excrete _____, and to raise pH, they excrete _____ and the lungs excrete CO2.

A

bicarbonate, HCO3-, H+

66
Q

A reversible reaction in which CO2+H20–>H2CO3–>HCO3-+H+ and vice versa is important in the _____. One _____ pH by releasing H+, the other _____ pH by binding H+.

A

ECF, lower, raises

67
Q

The _____ buffer system has the reaction H2PO4- HPO42- + H+. It is more important in buffering the _____ and _____ tubules.

A

phosphate, ICF, renal

68
Q

The _____ buffer system neutralizes 2-3 times as much acid as chemical buffers. Co2 is constantly produced by _____ metabolism and is normally eliminated by the _____ at an equivalent rate.

A

respiratory, aerobic, lungs

69
Q

_____ plasma CO2 (decreased pH) stimulates pulmonary ventilation, and _____ plasma CO2 (increased pH) inhibits pulmonary ventilation

A

increased, decreased

70
Q

The _____ can neutralize more acid or base than either the respiratory or chemical buffers. The _____ _____ secrete H+ into the tubular fluid. Most bind to bicarbonate, ammonia and phosphate buffers. Bound and free H+ are excreted in the _____. Other buffer systems only reduce H+ concentration by binding it to other chemicals.

A

kidneys, renal tubules, urine

71
Q

2 categories of acid-base imbalances

A

respiratory

metabolic

72
Q

Respiratory _____ occurs when the rate of alveolar ventilation fails to keep pace with the body’s rate of CO2 production. CO2 accumulates in the ECF and _____ its pH. This occurs in _____ where there is a severe reduction of functional alveoli.

A

acidosis, lowers, emphysema

73
Q

Respiratory _____ results from hyperventilation, as when a baby is crying, and CO2 is eliminated faster than it is produced.

A

alkalosis

74
Q

Metabolic _____ occurs when the increased production of organic acids such as lactic acid in anaerobic fermentation, ketone bodies as seen in alcoholism, and diabetes mellitus. It can also occur from the ingestion of acidic drugs like aspirin. Also, loss of base can result from chronic diarrhea and laxative overuse.

A

acidosis

75
Q

Metabolic _____, though rare, can result from the overuse of bicarbonates such as antacids and IV bicarbonate solution, or the loss of stomach acid from chronic vomiting.

A

alkalosis

76
Q

Either the kidneys compensate for pH imbalances of _____ origin, or the respiratory system compensates for pH imbalances of _____ origin. Uncompensated acidosis or alkalosis results in the pH imbalance that the body cannot correct without clinical intervention.

A

respiratory, metabolic

Western Medicine 502 (10 decks)

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