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Person Renal > Acid Base Balance PP#4 > Flashcards

Acid Base Balance PP#4 Flashcards

1
Q

Acid - Base physiology deals with what ion?

A

Hydrogen ion concentration

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2
Q

Weak acids and weak bases act as what?

A

Buffers

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3
Q

What do buffers do?

A

Minimize PH changes

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4
Q

How do buffers minimize PH changes?

A

donating or accecpting electrons

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5
Q

When are buffer most efficient?

A

pH=Pka

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6
Q

An acid is defined as a proton ________?

A

Donor

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7
Q

Base is defined as a proton ___________?

A

accecptor

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8
Q

What does a strong acid do in a solution?

A

Dissociates into H+ and anion

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9
Q

What does a strong base do in a solution?

A

avidly binds to H+

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10
Q

A weak acid or base _______ donates or accepts a proton.

A

Reversibly

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11
Q

Based on the Henderson Hasselbalch, pH is related to what?

A

Ratio of dissociated anion to undissociated acid

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12
Q

Name 5 body buffers

A 
Bicarb
HgB
Intracellular protiens
Phosphate
Ammonia
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13
Q

Bicarb buffer is most effective against what?

A

Metabolic disturbances

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14
Q

Bicarb is not effective against what?

A

Respiratory disturbances

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15
Q

What is the pKa of bicarb?

A

6.1

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16
Q

Where are high concentrations of bicarb buffer found?

A

ECF

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17
Q

How does the renal system compensate for acidosis?

A
  • Increased bicarb reabsorption

- Increase acid excretion

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18
Q

Where is 90% of filtered bicarb reabsorbed?

A

Proximal tubule

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19
Q

Where is 10% of filtered bicarb reabsorbed?

A

distal tubule

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20
Q

Where is the H+ pump located?

A

Distal tubule

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21
Q

What does the H+ pump in the distal tubule do?

A

Acidifying urine

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22
Q

CO2 is considered what?

A

Respiratory acid

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23
Q

Bicarb is considered what?

A

Metabolic base

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24
Q

How does the kidney increase acid content of urine?

A

H+ combines w/ phosphate to form phosphoric acid. Phosphoric acid becomes trapped in urine

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25
Q

In the PT, Thick Loop, and DT ammonium made from?

A

Glutamine

26
Q

Name 2 important tubular fluid buffers.

A

Phosphate

Ammonium

27
Q

How does phosphate effect PH?

A

It removes acid by combining w/ H+ and excreting in urine

28
Q

In the synthesis of ammonium from glutamine, what other compound is created?

A

Bicarb

29
Q

How is ammonium made in the collecting tubules?

A

H combines w/ NH3

30
Q

In the process of ridding the body of ammonia, the body also does what?

A

Conserve or make bicarb

31
Q

Metabolic alkalosis happens in what 2 situations?

A
  • Sodium depletion

- Increased aldosterone

32
Q

What type of alkalosis can occur w/ long term diuretic use?

A

Contraction alkalosis

33
Q

How does sodium depletion effect bicarb?

A

as Na is reabsorbed, CL must follow. Excess CL in the PT decreases bicarb

34
Q

What is base excess?

A

Amount of acid or base needed to return pH to 7.4

35
Q

What does a positive base excess indicate?

A

Metabolic alkalosis (too much base)

36
Q

What does a negative base excess indicate?

A

metabolic acidosis (too little base)

37
Q

How does acidosis effect K?

A

K ↑ 0.6 for each 0.1 ↓ in pH (potassium increase)

38
Q

How does acidosis effect Oxyhemoglobin dissociation curve?

A

Shift to right

39
Q

How does acidosis effect cardiac contractility?

A

Decreases contractility (CO)

40
Q

How does acidosis effect catecholamines?

A

decrease responsiveness

41
Q

What is a normal anion gap?

A

7-14

42
Q

What does the anion gap measure?

A

unmeasured anions

43
Q

Acidosis w/ high anion gap is caused by what?

A

strong, non-volatile acids

44
Q

What are 3 causes of high anion gap acidosis?

A
  • Uremia
  • DKA
  • Lactic Acidosis
45
Q

In high anion gap acidosis, what takes the place of bicarb?

A

unmeasured anions

46
Q

Normal anion gap acidosis is causes by what?

A

Hyperchloremia

47
Q

In normal anion gap acidosis, what takes the place of bicarb?

A

Chloride

48
Q

What a 2 causes of normal anion gap acidosis?

A
  • GI loss of bicarb (diarrhea)

- Renal loss of bicarb

49
Q

Dialysis may be need if patient has what?

A

Refractory acidosis

50
Q

What are 3 common underyling causes of metabolic acidosis?

A
  • Hypovolomeia
  • Anemia
  • Cardiogenic shock
51
Q

How would you treat metabolic acidosis?

A
  • Treat underlying cause

- Bicarb (vent only)

52
Q

Why would you not give bicarb to non-ventilated patients?

A

CO2 will rise

53
Q

How do you treat alkalosis?

A
  • HCl (rare)
  • Spironolactone
  • Stop Diuretics
  • Potassium
  • Stop NG
54
Q

When would you use spironoloactone to treat alkalosis?

A

If alkalosis is caused by increased aldosterone

55
Q

What kind of alkalosis do diuretics cause?

A

Chloride sensitive alkalosis

56
Q

What is the expected level of compensation for acute respiratory acidosis?

A

1 mEq/L ↑ in bicarb for every 10 mmHg ↑ in CO2

57
Q

What is the expected level of compensation for Chronic respiratory acidosis?

A

4 mEq/L ↑ in bicarb for every 10 mmHg ↑ in CO2

58
Q

What is the expected level of compensation for metabolic acidosis?

A

CO2 ↓ 1.2x the ↓ in bicarb

59
Q

What is the expected level of compensation for acute respiratory alkalosis?

A

2 mEq/L ↓ in bicarb for every 10 mmHg ↓ in CO2

60
Q

What is the expected level of compensation for Chronic respiratory alkalosis?

A

4 mEq/L ↓ in bicarb for every 10 mmHg ↓ in CO2

61
Q

What is the expected level of compensation for metabolic alkalosis?

A

CO2 ↑ 0.7x the ↑ in bicarb

Person Renal (6 decks)

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