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Molecules and Cells (Unit 1) > Acid Base Disorders > Flashcards

Acid Base Disorders Flashcards

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1
Q

•Filtered HCO3- cannot cross the __________ of the PCT cell. Instead it combines with the secreted ________to produce CO2 and H2O.

A

Apical membrane; H+

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2
Q

Examples of intracellular buffering agents

A

Proteins and Phosphate

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3
Q

In ___________ respiratory alkalosis HCO₃⁻ falls by 2 mmol/L for each 10 mm Hg fall in pCO₂

A

Acute

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4
Q

_______cells are able to generate NH₃ from _____________and other amino acids

A

Renal tubular; Glutamine

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5
Q

Type 1 Distal Renal Tubular Acidosis

  • Failure to secrete H⁺ by the alpha intercalated cells of the cortical __________ of distal nephron
  • Failure to secrete H⁺ in urine leads to inability to __________ urine and acidosis.
  • Urine pH is >_________
  • Renal ________ as a result of ________ urine, calciuria, and urinary citrate
  • Often associated with medullary sponge __________
  • Usually associated with ___________
  • ______ demineralization
A

Collecting ducts; acidify; 5.5; stones; alkaline; kidney; hypoalkamia; bone

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6
Q

Types of high anion gap metabolic acidosis

A
  • Diabetic ketoacidosis
  • Uremia, renal failure
  • Methanol toxicity
  • Paraldehyde toxicity
  • Salicylate toxicity
  • Alcohol ketoacidosis
  • Lactic acidosis
  • Ethylene glycol
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7
Q

____________ refers to a process in the body that tends to raise pH to > 7.44 due to decrease in acid or increase in alkali, leading to alkalemia in the blood

A

Alkalosis

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8
Q

•H⁺ will react with HCO₃̄ to form more ___________, and subsequently ____________.

A

H₂CO₃; H₂O and CO₂

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9
Q

Examples of extracellular buffering agents

A

bicarbonate and ammonia

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10
Q

Normal AG acidosis

A

due to loss of fluid rich HCO₃ from kidney or GT and counterbalanced by reabsorption of Cl⁻ with Na⁺ or K ⁺ to maintain neutrality

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11
Q

•Hypoalbuminemia causes __________ in anion gap.

A

decrease

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12
Q

Common mixed acid base disorders that result from metabolic acidosis paired with respiratory alkalosis

A

Diabetic ketoacidosis with hyoerventilation

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13
Q

Disturbances of respiratory component, compensation occurs through the _________

A

Kidney

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14
Q

The DCT reabsorption of HCO₃⁺ differs from PCT in what ways?

A
  • H+ secretion by the intercalated cells in DCT involves a H+-ATPase (rather than a Na+-H+ antiport)
  • HCO3- transfer across the basolateral membrane involves a HCO3–Cl- exchanger (rather than a Na+-HCO3- symport)
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15
Q

Normal anion gap acidosis is also known as ________________

A

hyperchloremic metabolic acidosis

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16
Q

The lower the pK the ___________ the acid, and the ________ it gives up it protons

A

Stonger; easier

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17
Q

The major source of NH4+ is from _________which enters the cell from the ____________(80%) and the ___________(20%)

A

Glutamine; pertibulular capillaries; Filtrate

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18
Q

CO2 is __________soluble and easily crosses into the ____________ of the PCT cell. In the cell, it combines with __________to produce bicarbonate.

A

Lipid; cytoplasm; OH-

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19
Q

The Na+- HCO3- symporter is __________ as it transfers ____ HCO3- for every_______Na+.

A

Electrogenic; three; one

20
Q

If __________is present, it’s a mixed disorder

A

Overcompensation

21
Q

_______________is the most common drug used in normal anion gap acidosis

A

Acetazolamide

22
Q

___________ including phosphates represent 14% of capacity

A

Plasma proteins

23
Q

The carbonic acid and bicarbonate system is the most important buffer system in the body because:

  • It restores normal pH (compensation) __________than other buffers
  • Through lungs by adjusting __________ to retain or expel CO₂. Begins immediately and reaches maximum in few hours
  • Or changing the HCO₃̄ concentration through ________. Begins immediately but maximum compensation takes 2-5 days
A

Faster; respiratory rate; kidneys

24
Q

High anion gap acidosis

A

HCO₃ is consumed in buffering excess H⁺

25
Q

Common mixed alkalosis disorders

A

Patient on a ventilator with continuous nasogastric aspiration

26
Q

•Ammonium (NH4) is produced predominantly within the ___________ cells.

A

Proximal tubular

27
Q

The higher the pKa the ___________ is the acid and the __________it holds to its protons

A

Weaker; stronger

28
Q

Causes of normal anion gap acidosis

A

Hyperalimentation
Acetazolamide use.
Renal tubular acidosis
Diarrhea
Uretosigmoid fistula
Pancreatic fistula

29
Q

About 85 to 90% of the filtered bicarbonate is reabsorbed in the ___________ and the rest is reabsorbed by the _________of the distal tubule and collecting ducts.

A

Proximal tubule; intercalated cells

30
Q

____________refers to an abnormal process or disease in the body that tends to lower pH <7.34 due to increase in acid or decrease in alkali leading to acidemia in the blood

A

Acidosis

31
Q

pKa is the pH at which the acid is _________

A

Half dissociated

32
Q

The HCO3- crosses the _______membrane via a Na+-HCO3- transporter. Is the Na+- HCO3- transportor a symporter or antiporter?

A

Basolateral; Symporter

33
Q

In ____________ respiratory acidosis, HCO₃⁻ increases by 3.5 mmol/L for each 10 mm Hg rise in pCO₂

A

chronic

34
Q

Common mixed acidosis disorders

A

Cardiac arrest (Hypoventilation and lactic acidosis)

Shock with respiratory failure

35
Q

Common mixed acid base disorders that result from respiratory acidosis paired with metabolic alkalosis

A

COPD with diuretics

Metabolic alkalosis with severe hypokalemia and respiratory weakness leads to hypoventilation

36
Q

_________________ refers to the ability of the buffer to resist pH changes

A

Buffering capacity

37
Q

____________ is a blood condition characterized by a pH of > 7.45 with decreased H⁺ concentration

A

Alkalemia

38
Q

In _________respiratory acidosis HCO₃⁻ increases by 1 mmol/L for each 10 mm Hg rise in pCO₂

A

Acute

39
Q

In _____________respiratory alkalosis HCO₃⁻ falls by 5 mmol/L for each 10 mm Hg fall in pCO₂

A

chronic

40
Q

The ________antiporter in the apical membrane is not electrogenic because an equal amount of charge is transferred in both directions.

A

Na+- H+

41
Q

The ratio of HCO₃̄ to PCO₂ must stay in the ratio of_________

A

20:1

42
Q

____________ system represents 6% of the buffering capacity

A

Carbonic Acid and bicarbonate

43
Q

•Low AG acidosis may be seen in

A
  • Hypoalbuminemia
  • Cirrhosis
  • Lithium intoxication
  • Severe hypercalcemia
  • Presence of a cationic paraprotein as in multiple myeloma
  • Increased Mg and Ca
  • Polymyxin B therapy
  • Polyclonal gammopathy
44
Q

____________ is a blood condition characterized by a pH < 7.35 with increased H⁺ concentration

A

Acidemia

45
Q
  • Type II pRTA:
  • Failure of ___________ cells to reabsorb filtered HCO₃
  • Defective absorption of other solutes may be seen leading to glycosuria, hypophosphatemia, hypokalemia
  • ___________ may be seen due to defective production of 1, 25 dihydoxyvitamin D
  • The __________cells function normally, so the acidemia is less severe than dRTA
  • Urine can be acidified to < __________ pH
A

Proximal tubulular; rickets; Distal intercalated; 5.5

46
Q

__________represents 80% of the chemical buffering capacity of blood

A

Hemoglobin

47
Q
  • Type IV RTA:
  • Failure of kidneys to secrete ___________
  • Failure of adrenal cortex to secrete ________
  • Renal tubular resistance to _________
  • __________ is not reabsorbed
  • ________and_______ are retained
  • The result is decreased renal ammonia formation and decreased elimination of H⁺
  • Associated with ___________ due to hypoaldosteronism
  • Acidemia is generally moderate
  • Urine can be acidified to below _______ pH
A

Renin

Aldosterone

Aldosterone

Na+

K+; H+

hyperkalemia

5.5

Molecules and Cells (Unit 1) (48 decks)

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