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EXAM 1: Pathophysiology > Acid-Base Imbalance (CHP 8) > Flashcards

Acid-Base Imbalance (CHP 8) Flashcards

Describe the intracellular and extracellular mechanisms for buffering changes in body pH. Compare the roles of the kidneys and respiratory system in regulation of acid-base balance. Differentiate between respiratory and metabolic alkalosis; and respiratory and metabolic acidosis. Describe causes of respiratory and metabolic acidosis; and metabolic and respiratory alkalosis. Compare and contrast the etiology and clinical manifestations of metabolic and respiratory acidosis and of metabolic and re

1
Q

______ and ________ = ECF

A

interstitial
plasma

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2
Q

intracellular water is found in …

A

cells

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3
Q

what is the body’s extracellular pH

A

7.35 - 7.45

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4
Q

acids and bases exist as _________ pairs/systems

A

buffer

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5
Q

acids are generated as ___________ of metabolic processes

A

byproducts

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6
Q

how do volatile acids exit the body?

A

lungs

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7
Q

how do nonvolatile/ fixed acids exit the body?

A

kidneys

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8
Q

the pH is regulated by: (3)

A
  1. chemical buffer systems (combine As and Bs to neutralize)
  2. lungs (get rid of CO2)
  3. kidneys (eliminate H+ & reabsorb/eliminate HCO3-)
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9
Q

the chemical buffer systems in the body, don’t do well with _______ changes

A

big

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10
Q

where are chemical buffer systems located?

A

within the ICF and ECF

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11
Q

buffer systems trade a strong acid for a ______ base OR trade a weak ______ for a strong base

A

weak
acid

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12
Q

what are the 3 main buffer systems?

A

bicarbonate buffer system

proteins

transcellular H+/K+ exchange system

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13
Q

the bicarbonate buffer system acts by __________ combining _____ & ______ to prevent changes in ____

A

immediately
A B
pH

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14
Q

transcellular H+/K+:
1. if plasma is acidic (too much _____)
2. H+ moves _____ cells, as ____ moves out
3. at risk for _________

why?

A

H+
in, K+
hyperkalemia

the ICF can be acidic (temporarily) but the ECF needs to stay between 7.35 - 7.45

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15
Q

________________ recognize changes in pH and tell the respiratory system to fix changes

A

chemoreceptors

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16
Q

pH above 7.45

A

alkalotic

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17
Q

pH below 7.35

A

acidic

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18
Q

increased ventilation = _______ PCO2

A

decreased

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19
Q

decreased _______ = increased PCO2

A

ventilation (RR)

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20
Q

lungs are the ___________ response, but can not be maintained indefinitely

A

fastest

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21
Q

what are the 3 roles of the kidneys in regulating pH?

A
  1. excretion of H+ (urine)
  2. reabsorption of HCO3-
  3. production of new HCO3-
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22
Q

pH changes with the kidneys take _______ but continue for ______ until pH returns to normal

A

hours
days

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23
Q

if the pH is too high, the kidneys will _________ or produce new ________ to lower the pH to normal

A

reabsorb
HCO3-

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24
Q

why does the body excrete H+?

A

to prevent hyperkalemia

(get rid of excess H+, K+ can go back into cell)

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25
what are the 4 renal control mechanisms?
1. H+ elimination and HCO3- conservation 2. tubular buffer system 3. K+/H+ exchange 4. Cli-/HCO3- exchange
26
the tubular buffer system stops eliminating _____ (dangerous to kidneys) and pairs them with _______ and then restarts excretion
H+ buffers
27
pH < 7.35 (acidosis) H+ elimination: K+ elimination: plasma [K+] _______kalemia
increases decreases increases hyper
28
pH > 7.45 (alkalosis) H+ elimination: K+ elimination: plasma [K+] _______kalemia
decreases increases decreases hypo
29
pH > 7.45 (alkalosis) Cl- elimination: HCO3- elimination:
decreases increases
30
pH < 7.35 (acidosis) Cl- elimination: HCO3- elimination:
increases decreases
31
why is renal regulation of pH more efficient?
they have more mechanisms that can be tailored to fixing the issue
32
what is the range for PCO2? this is the _______ component
35 - 45 mmHg respiratory
33
what is the range for HCO3-? this is the _______ component
22 -26 mmol/L kidney
34
why do we use an artery for ABGs?
more accurate to the systemic issues of the body (venous is dependent on the metabolic demands of surrounding tissue)
35
base excess =
metabolic alkalosis
36
base deficit =
metabolic acidosis
37
what does the anion gap measure?
difference between plasma concentrations of major cations (Na/K) and sum of measured anions (Cl- /HCO3-)
38
what is the normal anion gap value?
8 - 16 mEq/L
39
if the anion gap is high ...
there are more negative ions in the body, which means the body has kidney issues
40
metabolic
kidneys
41
R O M E
respiratory opposite metabolic equal
42
pH and HCO3- for: metabolic acidosis
low and low
43
respiratory compensation for metabolic acidosis:
increase RR (to decrease PCO2)
44
pH and HCO3- for: metabolic alkalosis
high and high
45
respiratory compensation for metabolic alkalosis:
decrease RR (to increase PCO2)
46
renal compensation for metabolic alkalosis:
decrease H+ excretion decrease HCO3- reabsorption
47
renal compensation for metabolic acidosis:
increase H+ excretion increase HCO3- reabsorption
48
pH and PCO2: respiratory acidosis
low pH high PCO2
49
pH and PCO2: respiratory alkalosis
high pH low PCO2
50
renal compensation for respiratory acidosis:
increase in H+ excretion increase in HCO3- reabsorption
51
renal compensation for respiratory alkalosis:
decrease in H+ excretion decrease in HCO3- reabsorption
52
__________ mechanisms: Provides a means to control pH when correction is impossible or cannot be achieved immediately
compensatory
53
what is an example of mixed acid-base disorders?
someone having COPD and then getting into a car crash and injuring a kidney (both systems are impaired and can't regulate pH)
54
what is an example of a single acid-base disorder?
getting into a car crash and injuring a kidney (lungs still available to regulate pH)
55
etiology of metabolic acidosis: (4)
1. increased production of acids (meds) 2. inability of kidneys to excrete acids 3. excessive loss of bicarb through kidneys or GI tract (upper GI all alkaline) 4. increased plasma [Cl-] (high Cl = low HCO3)
56
causes of metabolic acidosis: (3)
lactic acidosis ketoacidosis (alcoholic + diabetic) kidney failure/destruction
57
manifestations of metabolic acidosis (6)
N and V weakness confusion peripheral vasodilation decreased HR cardiac arrhythmias
58
signs of metabolic acidosis compensation
increased RR (kussmaul) hyperkalemia acid urine increased ammonia in urine
59
etiology of metabolic alkalosis: (3)
1. gain of base (oral or IV = antacids) 2. loss of fixed acids from the stomach (vomiting) 3. maintenance of increased bicarbonate levels by contraction of ECF volume, hypokalemia, hypochloremia (excessive diuretics)
60
causes of metabolic acidosis: (3)
excessive gain of bicarb (antacids) excessive loss of H+ ions (vomiting or gastric suction) diuretic therapy
61
manifestations of metabolic acidosis (5)
confusion hyperactive reflexes tetany hypotension arrhytmias
62
signs of metabolic alkalosis compensation (2)
decreased rate and depth increased urine pH
63
etiology of respiratory acidosis: (2)
acute or chronic conditions (decreased respiratory drive, lung disease, disorders of chest wall and respiratory muscles)
64
causes of respiratory acidosis: (4)
depression of respiratory center lung disease airway obstruction or disorders of chest wall (paralysis of resp m, chest injuries) breathing air with high CO2
65
manifestations of respiratory acidosis (3)
dilation of cerebral vessels depression of neural function stupor and coma
66
etiology of respiratory alkalosis (1_
hyperventilation
67
causes of respiratory alkalosis (2)
hyperventilation and fever
68
manifestations of respiratory alkalosis (3)
CONSTRICTION of cerebral vessels dizziness, panic, light-headed numbness and tingling of fingers/toes

EXAM 1: Pathophysiology (9 decks)

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