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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
In the PT, Thick Loop, and DT ammonium made from?
Glutamine
26
Name 2 important tubular fluid buffers.
Phosphate | Ammonium
27
How does phosphate effect PH?
It removes acid by combining w/ H+ and excreting in urine
28
In the synthesis of ammonium from glutamine, what other compound is created?
Bicarb
29
How is ammonium made in the collecting tubules?
H combines w/ NH3
30
In the process of ridding the body of ammonia, the body also does what?
Conserve or make bicarb
31
Metabolic alkalosis happens in what 2 situations?
- Sodium depletion | - Increased aldosterone
32
What type of alkalosis can occur w/ long term diuretic use?
Contraction alkalosis
33
How does sodium depletion effect bicarb?
as Na is reabsorbed, CL must follow. Excess CL in the PT decreases bicarb
34
What is base excess?
Amount of acid or base needed to return pH to 7.4
35
What does a positive base excess indicate?
Metabolic alkalosis (too much base)
36
What does a negative base excess indicate?
metabolic acidosis (too little base)
37
How does acidosis effect K?
K ↑ 0.6 for each 0.1 ↓ in pH (potassium increase)
38
How does acidosis effect Oxyhemoglobin dissociation curve?
Shift to right
39
How does acidosis effect cardiac contractility?
Decreases contractility (CO)
40
How does acidosis effect catecholamines?
decrease responsiveness
41
What is a normal anion gap?
7-14
42
What does the anion gap measure?
unmeasured anions
43
Acidosis w/ high anion gap is caused by what?
strong, non-volatile acids
44
What are 3 causes of high anion gap acidosis?
- Uremia - DKA - Lactic Acidosis
45
In high anion gap acidosis, what takes the place of bicarb?
unmeasured anions
46
Normal anion gap acidosis is causes by what?
Hyperchloremia
47
In normal anion gap acidosis, what takes the place of bicarb?
Chloride
48
What a 2 causes of normal anion gap acidosis?
- GI loss of bicarb (diarrhea) | - Renal loss of bicarb
49
Dialysis may be need if patient has what?
Refractory acidosis
50
What are 3 common underyling causes of metabolic acidosis?
- Hypovolomeia - Anemia - Cardiogenic shock
51
How would you treat metabolic acidosis?
- Treat underlying cause | - Bicarb (vent only)
52
Why would you not give bicarb to non-ventilated patients?
CO2 will rise
53
How do you treat alkalosis?
- HCl (rare) - Spironolactone - Stop Diuretics - Potassium - Stop NG
54
When would you use spironoloactone to treat alkalosis?
If alkalosis is caused by increased aldosterone
55
What kind of alkalosis do diuretics cause?
Chloride sensitive alkalosis
56
What is the expected level of compensation for acute respiratory acidosis?
1 mEq/L ↑ in bicarb for every 10 mmHg ↑ in CO2
57
What is the expected level of compensation for Chronic respiratory acidosis?
4 mEq/L ↑ in bicarb for every 10 mmHg ↑ in CO2
58
What is the expected level of compensation for metabolic acidosis?
CO2 ↓ 1.2x the ↓ in bicarb
59
What is the expected level of compensation for acute respiratory alkalosis?
2 mEq/L ↓ in bicarb for every 10 mmHg ↓ in CO2
60
What is the expected level of compensation for Chronic respiratory alkalosis?
4 mEq/L ↓ in bicarb for every 10 mmHg ↓ in CO2
61
What is the expected level of compensation for metabolic alkalosis?
CO2 ↑ 0.7x the ↑ in bicarb

Person Renal (6 decks)

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