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Renal > Acid Base Balance And Disorders > Flashcards

Acid Base Balance And Disorders Flashcards

1
Q

What is volatile acid

A

Can leave solution and enter atmosphere

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2
Q

What is fixed acids

A

Do not leave solution

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3
Q

What is organic acid

A

Participants or by products of aerobic metabolism

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4
Q

What are the acidic substances of the body

A

Carbonic acid
Phosphoric acid
Sulphuric acid

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5
Q

What are the organic acids of the body

A

Lactate
Acetoacetate
Pyruvate

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6
Q

What are the alkaline substances of body

A

Citrate

Bicarbonates

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7
Q

Normal pH of blood

A

7.35-7.45

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8
Q

Why is maintaining pH important ?

A

Enzyme activities
Normal metabolism
Normal coordination
Normal health

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9
Q

First line of defense in pH regulation

A

Blood buffer system (reacts in less than a second)

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10
Q

Second line of defense to regulate blood pH

A

Respiratory mechanism (reacts in seconds to minutes )

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11
Q

3rd line of defense to regulate blood pH

A

Renal mechanism (min to hours to react)

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12
Q

What is the chief buffer of the blood

A

Bicarbonate

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13
Q

What is the alkali reserve in the body

A

NaHCO3

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14
Q

The nicarbone buffer is connected to the …

A

Respiratory system

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15
Q

The phosphate buffer is connected to the

A

Excretory system

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16
Q

How does H2CO3 play on the respiratory system

A

Stimulates respiratory center -> hyperventilation for renoval from blood

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17
Q

What enzyme responsible for exhalation of H2CO3 as carbon dioxide

A

Carbonic anhydrase

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18
Q

Why is respiratory mechanism limited

A

Does not work on fixed acids like lactic acid

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19
Q

If low H2CO3 how is breathing ?

A

Hypoventilation -> slow and shallow

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20
Q

Most effective regulator of blood pH

A

Renal mechanism

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21
Q

Different mechanism of kidney that maintains acid base balance

A

Reabsorption of bicarbonate
Excretion of H+
Excretion of titrable acids
Excretion of ammonium ions

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22
Q

Urine pH

A

4.5-9.5

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23
Q

2 major acid base balance disturbances

A

Acidosis

Alkalosis

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24
Q

At what pH is there instant death

A

Less than 6.8

More than 8.0

25
Q

How does change in pH affect enzymes

A

Protonation or deprotonation of active site

Inacitvation

26
Q

How does pH affect excitability of nerve and muscle cells

A

Decreased pH -> decreased excitability

Increased pH -> increased excitability

27
Q

Relation between acidosis and potassium level

A

When acidosis more protons are secreted so less potassium are excreted
potassium retention affect cardiac function

28
Q

Can access these balance affect electrolytes and hormones

A

Yes

29
Q

What are the four primary disorders of acid base balance

A

Respiratory acidosis increased CO2
respiratory alkalosis decreased CO2
metabolic acidosis decreased bicarbonates
metabolic alkalosis increased by carbonate

30
Q

Disease that cause respiratory acidosis

A 
Cystic fibrosis 
pneumonia
Drugs or head edema trauma causing depression of respiratory center in the brain 
paralysis of respiratory or chest muscles 
Emphysema
 asthma 
pulmonary edema 
obstruction of respiratory tract
 congestive cardiac failure
31
Q

Common causes of metabolic acidosis

A

Too much alcohol

loss of bicarbonate during diarrhea

32
Q

How does lungs compensate for metabolic acidosis

A

Hyperventilation

33
Q

Metabolic alkalosis causes

A

Vomiting excessive

base intake

34
Q
A

Hypoventilation

35
Q

Causes of respiratory acidosis

A

Primary carbonic acid access
Increase carbon dioxide increased H2CO3
Defect in respiratory center of the brain
decreased elimination of H2CO3 by the lungs
hypoventilation

36
Q

Respiratory acidosis carbon dioxide level

A

Above 45 mm Hg hypercapnia

37
Q

Signs and symptoms of respiratory acidosis

A 
Restlessness 
restlessness 
 disorientation 
tremors 
convulsions, 
comatose 
respiratory rates repeats and gradually depressed 
skin is warm flushed  due to vasodilation because of excess carbon dioxide
38
Q

Treatment of respiratory acidosis

A

Restore ventilation
IV lactate solution
treat underlying dysfunction or disease

39
Q

What level of carbon dioxide indicates respiratory alkalosis

A

Carbon dioxide less than 35 mmHg

40
Q

Primary cause of respiratory. Alkalosis

A

Hyperventilation

41
Q

What conditions stimulates respiratory center which cause respiratory alkalosis

A 
Oxygen deficiency at high altitude 
pulmonary disease ,congestive heart failure causing hypoxia 
respiratory center lesions 
acute anxiety 
fever 
anemia 
early salicylates intoxication 
cirrhosis 
gram-negative sepsis ,meningitis
42
Q

Wx Most common cause of hyperventilation and thus alkalosis

A

anxiety

43
Q

Treatment of respiratory alkalosis

A

Treats underlying cause
breath into a paper bag
Iv chloride containing solution of chlorides which replace lost bicarbonate ions

44
Q

What is the primary alkali deficits

A

Metabolic

45
Q

When do you have metabolic acidosis in terms of bicarbonates concentration

A

When bicarbonates drop below 22meq

46
Q

Causes of metabolic acidosis

A

Loss of bicarbonate through diarrhea or renal dysfunction
overproduction of acids like lactic acid or ketones
failure of kidneys to excrete hydrogen ions

47
Q

Five major causes of metabolic acidosis

A 
Ingesting acid or substance metabolize to acid 
abnormal metabolism 
kidney insufficiencies 
strenuous exercise 
severe diarrhea
48
Q

What type of disease can cause abnormal metabolism leading to metabolic acidosis

A

Ketoacidosis
lacticacidosis
type one diabetes Molite us a controlled diabetes mellitus prolonged starvation shock hemorrhage violent exercise

49
Q

Symptoms of metabolic acidosis

A 
Headache 
 lethargy 
nausea 
vomiting 
diarrhea
 coma 
desth
50
Q

Treatment of metabolic acidosis

A

IV lactate solution

51
Q

When is metabolic alkalosis diagnosed with bicarbonates amount

A

When bicarbonate more than 26 meq

52
Q

Causes of metabolic alkalosis

A 
Excess vomiting with loss of stomach acid 
excessive use of alkaline drugs 
certain diuretics 
Endocrine disorders 
heavy ingestion of antacids 
severe dehydration
 Cushing syndrome 
prolonged exposure to x-ray and UV rays
53
Q

Metabolic alkalosis treatment

A

Baking soda
Electrolytes to replace lost
IV chloride containing solution
treat underlying disorder

54
Q

Compensation for metabolic alkalosis

A

Generally comes with renal dysfunction so cannot count on kidneys
Rhetoric in position difficult because hypoventilation limited by hypoxia

55
Q

Symptoms of metabolic alkalosis

A 
Slow and shallow respiration 
hyperactive reflexes 
tetany  
depletion of electrolytes 
atrial tachycardia 
dysrhythmias
56
Q

Main cation of body

A

Sodium

potassium

57
Q

Main anions

A

bicarbonates

Chloride

58
Q

Does anion gap increases or decreases in metabolic acidosis

A

Increases

Renal (16 decks)

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