Acid Base Keef

Question 1

Describe the relationship between H+,HCO3-, Cl-, K

Answer 1

H+ and K+ go together; H+ goes opposite of HCO3-

HCO3- goes opposite of Cl-

Question 2

When you have hyperkalemia, will you be acidodic or alkalotic?

Answer 2

acidodic

Question 3

When you have hypokalemia will you be acidodic or alkalotic?

Answer 3

you will be alkalotic

Question 4

If you add inorganic acid (or lose base) what results?

Answer 4

metabolic acidosis resulting in hyperkalemia

Question 5

If you have a patient undergoing diabetic ketoacidosis (permanent anion), what will result?

Answer 5

metabolic acidosis and NO change in potassium

Question 6

If you have a lack of insulin what will happen?

Answer 6

decrease in Na/K pump resulting in increase of extracellular potassium. Therefore if you give insulin you can get hypokalemia

Question 7

When you have diarrhea what will happen to your acid and potassium?

Answer 7

Acidosis and suprisingly HYPOKALEMIA because while K shifts out of cells into the plasma dirrea causes you to excrete and reduce your supply of potassium resulting in hypokalemia

Question 8

When you have renal failure, what will happen to your acid and potassium?

Answer 8

hyperkalemia

Question 9

When you have renal tubular acidosis, what will happen to your acid and potassium?

Answer 9

you will get hypokalemia because you pea out all of your potassium so while you at first get hyperkalemia you reduce your stores so much that you end up hypokalemia

Question 10

When you have diabetic ketoacidosis, what will happen to your acid and potassium?

Answer 10

Hyperkalemia due to absence of insulin! so then you will have acidosis too

Question 11

When you have lactic acidosis, what will happen to your acid and potassium?

Answer 11

Nothing : )

Question 12

Metabolic acidosis due to kidney problems can occur with what two diseases?

Answer 12

renal failure (chronic)
renal tubular acidosis (RTA)

Question 13

Where does distal (Type I) RTA occur?

Answer 13

Collecting tubule

Question 14

Where is there an apical H/K atpase?

Answer 14

in the distal tubule

Question 15

What will an increased apical membrane leakiness to H cause or an impaired apical H+/K+atpase or basolateral HCO3-/Cl- exchanger?

Answer 15

renal tubular acidosis and a urine that doesnt decrease below 5.5

Question 16

How low does the pH go in the proximal tubule, what about in the distal tubule?

Answer 16

6

4.4

Question 17

How can you make sure that you have distal (type 1) RTA and not type 2?

Answer 17

because type 1 occurs in the distal tubule and can be distinguished for proximal because when you put in NH4+ it wont go to the normal pH of 4.4 but will be higher. THis wont occur if you had problems in proximal tubule becase the distal would be able to compensate

Question 18

When you have Type I RTA what will happen to your urine HCO3-, urine pH, urine K+, urine Cl-, Plasma HCO3-, Plasma pH, Plasma K+, Plasma Cl-?

Answer 18

Urine HCO3- will INCREASE
Urine pH will increase
Urine potassium will increase
Urine Cl- will decrease
Plasma HCO3- will decrease
Plasma pH will decrease (metabolic acidosis)
Plasma K+ will decrease (hypokalemia)
Plasma Cl will increase

Question 19

Bone demineralisation, urinary stone formation, nephrocalcinosis (deposition of Ca2+ in kidney), and failure to thrive are all problems that have the same HCO3, H+, K+, Cl- levels as (blank)?

Answer 19

RTA

Question 20

If you have proximal (type II) RTA how do you know that it is proximal and not distal?

Answer 20

NH4CL will decrease urine pH below 5.5

Question 21

What is the treatment for renal tubular acidosis?

Answer 21

alkali replacement (NaHCO3 and sodium citrate)
Potassium citrate if hypokalemia is present

Question 22

Response to a single episode of vomiting will result in (blank)

Answer 22

metabolic alkalosis (less HCO3- reabsorbed, less New HCO3- formed)
ALKALOTIC urine
Increased urine Bicarb
increase potassium in urine

Question 23

What does this describe?
metabolic alkalosis
decreased plasma potassium
decreased plasma chloride
increased plasma HCO3-
increased PCO2
very low BUN
Low plasma creatinine
decreased Na+ urine
decreased K+ urine
decreased Cl- urine
ACIDIC urine

Answer 23

metabolic alkalosis associated with persistent vomiting

Question 24

The processes serving to retain volume ultimately result in a failure of the kidneys to regulate (blank)

Answer 24

acid base status

Question 25

What happens when you have hyperaldosteronemia?

Answer 25

increased H+ secretion
increased K+ secretion
increased Na+ reabsoprtion (leading to hypertension)

Question 26

When you have respiratory acidosis what happens and what is the compensatory mechanism?

Answer 26

increase CO2 and increased HCO3- to compensate

Question 27

When you have metabolic acidosis what happens and what is the compensatory mechanism?

Answer 27

you have decreased HCO3- and decreased CO2 to compensate

Question 28

When you have respiratory alkalosis what happens and what is the compensatory mechanism?

Answer 28

decreased CO2, which decreased HCO3- to compensate

Question 29

When you have metabolic alkalosis, what happens and what is the compensatory mechanism?

Answer 29

increased HCO3- and an increase in CO2 to compensate

Question 30

(blank) will cause your urine to be alkalotic due to decreased Hydrogen in your urine because you vomited it all, this will not allow bicarb to combine with the H= to be reabsorbed so it will get peed out. However, in (blank) you will have acidic urine because you will be dehydrated which will make aldosterone work which will cause potassium to be secreted and cause hypokalemia and hypokalemia makes hydrogen get secreted and therefore you will get hco3- reabsorption and acidic urine.

Answer 30

One episode of vomiting

prolonged vomiting