Acid Base Balance and Pathophysiology-Exam 2: Ch.3 Flashcards

1
Q

Type of kidney buffers

A

bicarb, ammonia, phosphate

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2
Q

Causes of metabolic alkalosis

A

prolonged vomiting, nasogastric suction; NaHCO3 ingestion, diuretic therapy without K

-with hyperaldosteronism, sodium retention and loss of hydrogen and potassium ions

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3
Q

Causes of respiratory acidosis

A

Causes: COPD, asthma, obesity

Manifestations: increased resp .rate, decreased sensorium, GI distress (n/v/d), and ventricular arrhythmias

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4
Q

Causes of respiratory alkalosis

A

Causes: anxiety, tumor, fever, pain, trauma, severe anemia

Manifestations: decreased resp. rate with increased depth, reflect loss/decrease in electrolyte (muscle cramps, weakness, paresthesias), atrial tachycardia

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5
Q

Role of kidneys in maintaining acid base homeostasis

A

The kidneys have two main ways to maintain acid-base balance - their cells reabsorb bicarbonate HCO3− from the urine back to the blood and they secrete hydrogen H+ ions into the urine.

By adjusting the amounts reabsorbed and secreted, they balance the bloodstream’s pH.

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6
Q

Acidemia

A

a state in which the pH of arterial blood is less than 7.35.

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7
Q

Alkaemia

A

a state in which the pH of arterial blood is greater than 7.45.

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8
Q

Acidosis

A

a systemic increase in hydrogen ion concentration or loss of base.

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9
Q

Define pH

A

Each unit of change represents a tenfold change in acidity or alkalinity and that is the negative logarithm of the effective hydrogen‐ion concentration in moles H+ ions per liter of the solution. Pure water is 1x10e(‐7) moles H+ ions per liter, so the pH value of pure water is 7 .

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10
Q

Metabolic acidosis clinical mafnifestations

A
  1. kussmal respirations
  2. early symptoms is headache and lethargy
  3. anorexia, nausea, vomiting, diarrhea, and abd discomfort
  4. ketoacidosis
  5. deep respirations indicate resp. compensation
    - if acidosis progresses it can lead to coma then ultimately death
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11
Q

Decreased blood pH leads to

A
  • decreased myocardial contraction, causing decreased bp
  • arterial vasodilation
  • pH below 7.15 to 7.2, the effect of acidemia is prominent
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12
Q

Clinical Manifestations of metabolic alkalosis

A
  • irritated, twitching, and confused
  • n/v/d
  • some may have severe cramping, paresthesia, or even tetany, but in other with similar electrolytes, they have no s/s
  • hyperactive reflexes
  • tetany
  • confusion/convulsions
  • cardiovascular abnormalities due to hypokalemia
  • atrial tachycardia
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13
Q

Electrolytes effected by metabolic alkalosis

A

potassium, calcium, and magnesium

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14
Q

Compensatory process for metabolic acidosis

A

hyperventilation

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15
Q

Compensatory process for metabolic alkalosis

A

hypoventilation

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16
Q

Compensatory process for respiratory acidosis

A

renal HCO3-retention

17
Q

Compensatory process for respiratory alkalosis

A

renal HCO3- excretion

18
Q

Acidosis

A

systemic increase in hydrogen ion concentration or a loss of base
pH <7.35

19
Q

Alkalosis

A

systemic decrease in hydrogen ion concentration or an excess of base
pH >7.45

20
Q

Hydrogen ion is necessary for:

A

for maintaining membrane integrity, enzyme activity.

21
Q

Inside cell

A

potassium is high

sodium is low

22
Q

Outside of cell

A

potassium is low
sodium is high
calcium high

23
Q

What is the reciprocal K+ exchange in alkalosis

A
  • H+ moves extracellularly

- K+ moves intracellularly

24
Q

What is the reciprocal K+ exchange in acidosis

A
  • H+ moves intracellularly

- K+ moves extracellularly

25
Normal pH is
7.35 (slightly alkaline....pH of water is 7 which is neutral)
26
Buffer
a substance capable in solution of neutralizing both acids and bases and thereby maintaining the original acidity or basicity of the solution.
27
Buffering
responding to changes and maintaining the original acid‐base status.
28
pH
Each unit of change represents a tenfold change in acidity or alkalinity and that is the negative logarithm of the effective hydrogen‐ion concentration in moles H+ ions per liter of the solution. Pure water is 1x10e(‐7) moles H+ ions per liter, so the pH value of pure water is 7.
29
Importance of hydrogen ion
necessary to maintain membrane integrity, enzyme activity. Most pathologic conditions disturb acid‐base balance, and the degree of severity may be more harmful than the disease process.
30
How do kidneys help control acid base balance
by excreting hydrogen ions and generating bicarbonate that helps maintain blood plasma pH within a normal range. Protein buffer systems work predominantly inside cells. Lungs exhale CO2 from the body and adjust the blood pH.yh7
31
Buffers
1. protein buffer 2. phosphate buffer 3. ammonia buffer 4. bicarbonate-carbonic acid buffer
32
What kind of charge do proteins have
negative
33
Where to proteins mainly function
intracellular buffer system
34
Plasma buffers
1. hemoglobin 2. phosphate 3. bicarb-carbonic acid
35
Intracellular buffers
1. protein 2. phosphate 3. other ions (ex: K+)
36
Kidney buffers
1. bicarb 2. ammonica 3. phosphate
37
Causes of metabolic acidosis
cancer, carbon monoxide poisoning, exercise, liver failure, hypoglycemia
38
causes of metabolic alkalosis
diuretics, antacids, certain laxatives, steroids, baking soda