Acid Base - Muster

Question 1

What is normal Na⁺ level?

Answer 1

140

Question 2

What is normal Cl^- level?

Answer 2

100

Question 3

What is normal HCO₃^- level?

Answer 3

24

Question 4

What is a normal Anion Gap?

Answer 4

12

(8-12)

Question 5

What is the isohydric principle?

Answer 5

• multiple acid/base pairs in solution will be in equilibrium with one another
• if you change [H⁺] => you change every acid/base pairing in the body

Question 6

What is Le Châtelier’s Principle?

Answer 6

Any system at equilibrium, when disturbed, will adjust itself to (partially)counteract the disruption.

=> re-establishes a new equilibrium

Question 7

What is acidemia?

Answer 7

increase in [H⁺] => represents decreased pH

***says nothing about cause

Question 8

What is alkalemia?

Answer 8

decrease in [H⁺] => representing increased pH

***tells nothing about cause

Question 9

What is acidosis?

Answer 9

metabolic or respiratory process that => leads to acidemia

• Caused by:
  
  • increased pCO₂
  • decreased HCO₃^-

Question 10

What is alkalosis?

Answer 10

metabolic or respiratory process that => leads to alkalemia

• Caused by:
  
  • decreased pCO₂
  • increased HCO₃^-

Question 11

What is the primary disturbance and compensatory response in metabolic acidosis?

Answer 11

• Primary disturbance = decreased [HCO₃^-]
• Compensatory response =
  
  • decrease pCO₂
  • decrease pH
  • Hyperventilation (immediate)

Question 12

What is the primary disturbance and compensatory response in metabolic alkalosis?

Answer 12

• Primary disturbance = increased [HCO₃^-]
• Compensatory response =
  
  • increase pCO₂
  • increase pH
  • Hypoventilation (immediate)

Question 13

What is the primary disturbance and compensatory response in respiratory acidosis?

Answer 13

• Primary disturbance = increased pCO₂
• Compensatory response =
  
  • increase [HCO₃^-]
  • decrease pH
  • increased renal [HCO₃^-] reabsorption (delayed)

Question 14

What is the primary disturbance and compensatory response in respiratory alkalosis?

Answer 14

• Primary disturbance = decreased pCO₂
• Compensatory response =
  
  • decrease [HCO₃^-]
  • increase pH
  • decrease renal [HCO₃^-] reabsorption (delayed)

Question 15

What is the role of ammonium (NH₄⁺) in the renal control of acid/base homeostasis?

Answer 15

• Method to carry H⁺
• Ability to excrete excess acid

Question 16

What are some common conditions that lead to Respiratory Acidosis?

Answer 16

• A primary rise in pCO₂ due to lack of ventilation
  
  • Drug induced - morphine, succinylcholine, heroin
  • Pulmonary edema
  • Obstruction
  • COPD

Question 17

What are some common conditions that lead to Respiratory Alkalosis?

Answer 17

• A primary decrease in pCO₂
  
  • Hyperventilation
  • Panic attack
  • High altitude

Question 18

What are some common conditions that lead to Metabolic Acidosis?

Answer 18

• Decreased [HCO₃^-] due to increased acid
  
  • lactate
  • ketones
  • salicylates
  • methanol
  • ethylene glycol
  • DKA
  • diarrhea
  • laxative abuse

Question 19

What are some common conditions that lead to Metabolic Alkalosis?

Answer 19

• A primary rise in [HCO₃^-] due to less acid
  
  • vomiting
  • antacid use
  • loop diuretics
  • hyperaldosteronism

Question 20

What is the primary buffering system?

Answer 20

CO₂ + H₂O <=> H₂CO₃ <=> H⁺ + HCO₃^-

Question 21

What is the Kassier-Bleich equation?

Answer 21

[H⁺] = 24(pCO₂) / [HCO₃^-]

Question 22

What cells participate in the renal regulation of acid/base homeostasis in the kidneys?

Answer 22

• Proximal tubule cells
  
  • reclaim bicarb
  • create ammonium (NH₄⁺)
• Alpha-intercalated cells (collecting duct)
  
  • secrete acid via H⁺ ATPase and K⁺/H⁺ ATPase
  • create ammonium (NH₄⁺) - 2/3
  • create H₂PO₄ - 1/3
• Beta-intercalated cells (collecting duct)
  
  • secrete bicarb via Cl^-/HCO₃^- antiporter