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214.201 > Acid-base Balance > Flashcards

Acid-base Balance Flashcards

1
Q

What donates free hydrogen ion when dissolved in water?

A

Acid

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2
Q

What accepts free hydrogen ion when dissolved in water?

A

Base

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3
Q

What is normal blood pH?

A

7.35-7.45 (slightly acidic)

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4
Q

What does normal body metabolism produce that needs to be removed & what are examples of these?

A

Acid

  • Carbonic acid from CO2 –aerobic respiration
  • Lactic acid – from anaerobic respiration (lactoacidosis)
  • Ketones – from use of lipids as an energy source, eg during starvation or diabetes (ketoacidosis)
  • Sulphuric acid from oxidation of sulphur containing amino acids
  • Phosphoric acid from the breakdown of phosphoproteins and ribonucleotides
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5
Q

What are examples of buffer system?

A
  • Bicarbonate
  • Phosphate
  • Protein
  • Respiratory
  • Renal
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6
Q

What is a chemical buffer system?

A
  • System to maintain pH level

- Buffers react with a relatively strong acid (or base) to replace it with a relatively weak acid (or base)

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7
Q

What is the buffer equation?

A

CO2 + H2O H2CO3 H + HCO3-

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8
Q

What is the bicarbonate carbonic acid buffer?

A
  • Catalysed by carbonic anhydrase in red blood cells

- Regulates pH by maintaining the ratio of 20 bicarbonate ions:1 carbonic acid

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9
Q

What is the respiratory regulation of hydrogen?

A
  • Physiological buffer (slower effect)
  • Eliminate carbon dioxide (an acid)
  • During CO2 unloading (at lungs), reaction shifts
    to left (and H+ is incorporated into H2O)
  • During CO2 loading (at tissues), reaction shifts to right (and H+ is buffered by proteins
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10
Q

How does the respiratory buffer get triggered and respond?

A
  • Medullary and peripheral chemoreceptors detect high levels of carbon dioxide and hydrogen in the blood
  • Increase respiratory rate & depth
  • Remove carbon dioxide from blood, reducing hydrogen concentration
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11
Q

How does hypoventilation affect pH balance?

A

Hypoventilation causes respiratory acidosis if pH < 7.35 due to the increase in carbon dioxide driving the buffer system to the right, thereby raising hydrogen ion concentrations

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12
Q

How does hyperventilation affect pH balance?

A

Hyperventilation causes respiratory alkalosis if pH > 7.45 from too much loss of carbon dioxide driving the buffer system to the left, thereby lowering hydrogen ion concentrations

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13
Q

How does renal regulation affect pH balance?

A
  • Kidney can excrete and retain bicarbonate and hydrogen ions, influencing pH
  • Response take several hours
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14
Q

How is pH compensated?

A

If either the lungs or kidney experience impaired function, the other organ compensate

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15
Q

What encompasses acid-base disorders?

A

Can be:

  • Acidosis or alkalosis
  • Respiratory or metabolic
  • Partly or fully compensated or uncompensated
  • Or it can have both a respiratory & metabolic cause
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16
Q

What is respiratory acidosis and what are the levels & causes?

A
  • Impaired respiratory function causing low pH
  • In uncompensated respiratory acidosis, pH less than 7.35, carbon dioxide levels will be elevated while bicarbonate levels are now
    Causes:
  • Inadequate oxygen supply causes hypoxia & hypoxemia
  • Reduced ability to regulate pH
17
Q

What is metabolic acidosis and what are the levels & causes?

A
  • From cause that is not respiratory e.g. due to excessive buffering or loss of buffer causing low bicarbonate levels
  • In uncompensated metabolic acidosis, pH less than 7.35, low bicarbonate, normal carbon dioxide
    Causes:
  • Severe diarrhoea
  • Renal disease
  • Diabetes
18
Q

How can acidosis cause hyperkalemia?

A
  • Increased hyrogen ions exchange causes increase potassoim
    1) Hydrogen enters cells in exchanges for potassium leaving into ECF
    2) Acidosis cause decreased secretion of potassium in kidney
  • Hyperkalemia can cause cardiac arrhythmias
19
Q

What is respiratory alkalosis and what are the levels & causes?

A
  • High pH from impaired respiratory function
  • In uncompensated respiratory alkalosis pH is above 7.45, low carbon dioxide, normal bicarbonate
    Causes are hyperventilation causes by:
  • Hypoxemia
  • Strong emotions
  • Brain tumour or injury to respiratory controls
20
Q

What is metabolic alkalosis and what are the levels & causes?

A
  • Alkalosis without respiratory cause
  • In uncompensated metabolic alkalosis, pH is above 7.45, high bicarbonate, normal carbon dioxide
    Causes:
  • Vomiting or gastric suctioning
  • Overdose of antacids
  • Adrenal tumours over secreting aldosterone
21
Q

How do you identify compensation of acid-base imbalances?

A

The levels will opposes the observed deviation in pH

22
Q

What is the compensation of respiratory acidosis?

A
  • Kidneys retain bicarbonate and secrete hydrogen

- Normal/acidic pH, high carbon dioxide & high bicarbonate

23
Q

What is the compensation of respiratory alkalosis?

A
  • Kidneys excrete bicarbonate and retain hydrogen

- Normal/basic pH, low carbon dioxide & low bicarbonate

24
Q

What is the compensation of metabolic acidosis?

A
  • Respiratory system increases respiratory rate & depth since increased hydrogen levels stimulate respiratory centres
  • Normal/acidic pH, low bicarbonate & low carbon dioxide
25
Q

What is the compensation of metabolic alkalosis?

A

Respiratory system decreases respiratory rate & depth since low hydrogen levels decrease respiratory drive
- Normal/basic pH, high bicarbonate & high carbon dioxide

26
Q

How can disorders be identified?

A

ABG - arterial blood gases

27
Q

What is the normal carbon dioxide level?

A

35-45 mmHg

28
Q

What is the normal bicarbonate level?

A

80-100 mmHg

29
Q

What is the normal oxygen level?

A

22-32 mmol/L

30
Q

What is the normal oxygen saturation level?

A

95-99%

214.201 (17 decks)

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