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Respiratory System > Acid Base Balance > Flashcards

Acid Base Balance Flashcards

1
Q

What is alkalaemia?

A

Plasma pH >7.45

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2
Q

What is acidaemia?

A

Plasma pH <7.35

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3
Q

What is the effect of alkalaemia?

A

Lowers free calcium - Ca2+ ions come out of solution

Increases neuronal excitability - leads to paraesthesia + tetany

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4
Q

What is the effect of acidaemia?

A

Increases plasma K+ concentration - effects excitability of muscle

Denatures proteins - effects muscle contractility, glycolysis + hepatic function

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5
Q

How is pH regulated?

A

CO2/HCO3- buffer system

CO2 + H2O H+ + HCO3-

Direction dependent on concentrations of reactants/products

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6
Q

How is pCO2 determined?

A

Ventilation - controlled by chemo receptors

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7
Q

How is [HCO3-] determined?

A

Controlled by the kidneys - variable recovery of HCO3- and secretion of H+

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8
Q

How does the kidney control [HCO3-]?

A

Recovery

Creation

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9
Q

How does the kidney recover HCO3-?

A

HCO3- filtered at glomerulus

Mostly recovered in PCT by a sodium cotransporter

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10
Q

How is HCO3- created in the kidney?

A

Glutamine -> α-ketoglutarate

Produces HCO3- + NH4+

HCO3- enters ECF
NH4+ enters lumen - excreted in urine

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11
Q

How does the kidney control H+?

A

Secrete H+ that is produced from CO2 reacting with water

H+ is actively secreted

H+ buffered by ammonia and phosphate

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12
Q

How is acid excreted?

A

In the urine

  • H+
  • buffered by phosphate
  • reacted with ammonia to form ammonium
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13
Q

How much acid is secreted per day?

A

50-100 mmol H+ per day

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14
Q

What is the effect of acidosis on potassium?

A

Acidosis -> hyperkalaemia

  • potassium ions move out of cells
  • decreased potassium excretion in nephron
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15
Q

What is the effect of alkalosis on potassium?

A

Alkalosis -> hypokalaemia

  • potassium ions move into cells
  • increased secretion of potassium in nephron
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16
Q

What is the effect of hyperkalaemia on acid base balance?

A

Makes intracellular pH of tubular cells more alkaline

H+ ions move out of cells

This favours HCO3- secretion

METABOLIC ACIDOSIS

17
Q

What is the effect of hypokalaemia on acid base balance?

A

Makes intracellular pH of tubular cells more acidic

H+ ions move into cells

This favours H+ secretion and HCO3- recovery

METABOLIC ALKALOSIS

18
Q

How does hypoventilation effect acid base balance?

A

Hypoventilation -> hypercapnia

Hypercapnia -> fall in plasma pH

RESPIRATORY ACIDOSIS

19
Q

How does hyperventilation effect acid base balance?

A

Hyperventilation -> hypocapnia

Hypocapnia -> rise in plasma pH

RESPIRATORY ALKALOSIS

20
Q

What is compensation?

A

Changes in breathing rate to compensate for changes in [HCO3-]
OR
Changes in [HCO3-] to compensate for respiratory acidosis/alkalosis

21
Q

What is the anion gap?

A

Difference between measured cations and anions

22
Q

How do you calculate the anion gap?

A

([Na+]+[K+]) - ([Cl-]+[HCO3-])

23
Q

What causes the anion gap to be increased?

A

HCO3- replaced by other anions - typically of metabolic acids

24
Q

What happens to the anion gap in renal causes of acidosis?

A

Unchanged

Kidney not making enough HCO3- so its replaced by Cl-

25
Q

What conditions cause respiratory acidosis?

A

Type 2 resp failure

  • severe COPD
  • severe asthma
  • drug overdose
26
Q

What conditions can cause respiratory alkalosis?

A

Hyperventilation

Type 1 resp failure
- chronic hyperventilation

27
Q

What conditions can cause metabolic acidosis with an increased anion gap?

A

Diabetic ketoacidosis
Lactic acidosis
Uraemic acidosis

28
Q

What conditions can cause metabolic acidosis with a normal anion gap?

A

Renal tubular acidosis

Severe persistent diarrhoea

29
Q

What conditions can lead to metabolic alkalosis?

A

Severe prolonged vomiting

Diuretics

Respiratory System (23 decks)

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