Acid Base- Muster

Question 1

Define Isohydric Principle

Answer 1

when there is a change in the [H+] concentration, it affects ALL acid-base pairs in the ENTRIE system.

Question 2

What is the primary buffering system in the human body? What are the three less influential buffering systems?

Answer 2

Primary = bicarb (via carbonic anhydrase)
Others = Hgb, bone, Phosphorus

Question 3

Define Le Chatelier’s Principle

Answer 3

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

In other words - reestablish equilibirum

Question 4

Does ionization USUALLY increase or decrease function?

Answer 4

Decrease!

Question 5

Define Acidemia/alkalemia

Answer 5

is an increase or decrease in H+ ion representing a change in pH. Tells NOTHING about cause

Question 6

Define acidosis/alkalosis

Answer 6

= The description, either metabolic or respiratory of the process that leads to the acidemia or alkalemia

Question 7

What is normal pH?

Answer 7

7.4

Question 8

What is the Kassier-Bleich equation?

Answer 8

[H+] = (24*pCO2)/[HCO3-]

Question 9

What are some physiological consequences of Acidosis?

Answer 9

Increased respiration
Kussmaul breathing
Depresses cardiac contractility
Increases circulationg catecholamine levels
Stimulates protein catabolism
Leads to bone loss

Question 10

What are some physiological consequences of alkalosis?

Answer 10

Hypoventilation
Cardia arrhythmias
Shifts oxygen dissociation curve to the LEFT, decreasing oxygen delivery to tissues
Increased lactate production

Question 11

What are the two primary mechanisms for managing acid load?

Answer 11

Buffering (bicarb equation)

Renal Excretion

Question 12

What are the two things kidneys MUST do to manage acid?

Answer 12

1. Reclaim all bicarbonate

2. excrete the acid excess

Question 13

Ionization INCREASES the efficiency of what three things?

Answer 13

Carbonic Anhydrase
Na-H pump (lumenal membrane)
Glutamine uptake

Question 14

What 4 things will increase the action of the Na-H pump on the luminal side of proximal tubule cell?

Answer 14

Increased AGII
Increased sympathetics
Decreased pH
Increased CO2

Question 15

What are two ways H+ is able to leave the proximal tubule cell into the lumen?

Answer 15

The Na+/H+ pump & as NH4+ in the NH4+/Na+ pump

Question 16

What can glutamine be split into by glutaminase in the proximal tubule?

Answer 16

NH4+ and 2 HCO3-

NH4+ goes to lumen, Bicarbonate gets reabsorbed

Question 17

Would B intercalated or alpha intercalated cells be more useful for ALKALEMIA?

Answer 17

B-intercalated! It pumps HCO3- INTO the lumen for excretion

alpha-intercalated cells cause reabsorption of bicarbonate-polar opposite of B-intercalated cells!

Question 18

If there are respiratory issues what organ is responsible for compensating? how long does it take?

Answer 18

Kidneys must compensate, does this slowly, over a period of days

Question 19

If there are metabolic issues derive from non-respiratory issues what organ compensates?

Answer 19

The lungs! They can do this in a matter of MINUTES.

Question 20

An acidosis will be caused by manipulating the Kassier-Bleich equation in what 2 ways?

Answer 20

Increase pCO2

Decrease Bicarbonate

Question 21

An alkalosis will be caused by manipulating the Kassier-Bleich equation in what 2 ways?

Answer 21

Decrease pCO2

Increase bicarbonate

Question 22

If not using the Kassier-Bleich equation, what easy numbers can you memorize to help you determine pH from [H+]?

Answer 22

40 –> 7.4
50 –> 7.3
60 –> 7.2
70 –> 7.1

Question 23

How do we deal with non-volatile (non-carbonic) acids that are derived from the metabolism of proteins?

Answer 23

They are excreted in the kidneys

Question 24

Via what transporter does bicarbonate get reabsorbed in the proximal tubule?

Answer 24

Na+/3HCO3- symporter

Question 25

Via what transporter does Ammonium enter the lumen in the proximal tubule?

Answer 25

Secondary active transport NH4+/Na+ (ammonium out, sodium in)

Question 26

What are the 2 ways that bicarbonate is created in the proximal tubule cells?

Answer 26

Via Carbonic Anhydrase | Via Glutamine

Question 27

What 2 things can lower pH and therefore increase the pump activity in the proximal tubule?

Answer 27

Drop in bicarbonate Increase in CO2 (Hence the 2 things that cause acidosis!)

Question 28

1/3 of the Urinary H+ is buffered by what?

Answer 28

phosphorous

Question 29

What is the cause of a respiratory acidosis?

Answer 29

Primary rise in pCO2 due to lack of ventilation

Question 30

Metabolic acidosis can occur via what 2 ways?

Answer 30

1. Increase in H+ | 2. Decrease in bicarbonate

Question 31

What is lost in excess in a person with diarrhea?

Answer 31

Bicarbonate

Question 32

What kinds of things will cause an increase in H+?

Answer 32

``` Lactate Ketones Methanol Ethylene glycol Aspirin ```

Question 33

What do the kidneys do during a metabolic acidosis?

Answer 33

Try to reabsorb all bicarbonate! But this won't be enough. Must also excrete the acid being produced!

Question 34

When H+ starts do decrease due to a respiratory alkalosis, what cell type may appear? Why?

Answer 34

Beta-intercalated cells! | Increase bicarbonate secretion!

Question 35

What does the liver do in a respiratory alkalosis?

Answer 35

It converts ammonium to urea, which consumes bicarbonate! So the liver helps too!

Question 36

What does a metabolic alkalosis mean?

Answer 36

Net loss of H+ from extracellular space

Question 37

What can rise drastically during a metabolic acidosis due to vomiting etc?

Answer 37

Bicarbonate