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Medical Phys II > Acid/Base Normal/Pathophyisology > Flashcards

Acid/Base Normal/Pathophyisology Flashcards

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USMLE® Step 1 flashcards
1
Q

What is a pH <7.35

A

Acidic

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2
Q

What is a pH of >7.4

A

Basic

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3
Q

what does pH=

A

-log 10 [H+]

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4
Q

What is the most acidic body fluid?

A

Gastric Juices

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5
Q

Is pancreateic fluid acidic or basic and why?

A

Basic- helps neutralizes chyme from stomach upon entering duodenum

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6
Q

How are volatile forms body acids (ex-carbonic acid H2CO3) eliminated?

A

CO2

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7
Q

How are nonvolatile body acids (ex- sulfuric pohsphoric) eliminiated?

A

Renal tubules

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8
Q

Which process is faster at getting rid of acid- lungs or kidney?

A

Lungs

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9
Q

What is lactic acid formed by?

A

Anaerobic respiration of glucose

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10
Q

What is a buffer?

A

Can absorb excessive H+ or OH- without significant change in pH

Work as weak acid and conjugate base

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11
Q

Where are buffers located?

A

ICF and ECF

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12
Q

For the bicarbonate buffer system, what is the weak acid?

A

H2CO3 (carbonic acid)

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13
Q

What is the base in the bicarbonate buffer system?

A

Bicarbonate (HCO3-)

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14
Q

As CO2 goes up or down, H2CO3….

A

does the same

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15
Q

How do lungs decrease H2CO3?

A

by eliminating CO2

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16
Q

What do kidneys do with bicarbonate?

A

Reabsorb or generate new

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17
Q

If bicarbonate decreases, what happens to pH?

A

pH drops

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18
Q

If the bicarbonate concentration goes up, what happens to pH?

A

pH goes up

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19
Q

What is compensation ?

A

Normal ratio

Abnormal values

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20
Q

What is correction?

A

Values return to normal, uses the same system

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21
Q

What is an example of protein buffering?

A

Hemoglobin

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22
Q

What is arterial blood pH <7.4

A

Acidemia

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23
Q

What is a systemic increase is [H+]

A

Acidosis

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24
Q

What is arterial blood pH >7.45?

A

Alkalemia

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25
Q

What is a systemic decrease in [H+]

A

Alkalosis

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26
Q

What is the normal Pa CO2 range?

A

36-44 mm Hg

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27
Q

What is the normal HCO3- range?

A

22-26 mEq/ L

28
Q

As [H+] increases what happens to pH?

A

decrease

29
Q

Why is urine acidic?

A

Excess hydrogen ions are shed through urine

(5.0-6.0)

30
Q

Where does carbonic acid come from?

A

Co2

31
Q

What is the pK value?

A

the pH where 1/2 of the buffer layer is dissociated

32
Q

What is the Henderson-Hasselbalch Equation?

A

pH = pK + log [base]/[acid]

33
Q

What type of Hb is the better buffter?

A

unsaturated

34
Q

Where does renal buffering occur?

A

DCT and collecting ducts (some PCT)

35
Q

When buffers in tubular fluid combine with H+, what do they combine with?

A

Dibasic phosphate (when combined turns into monobasic phosphate- stays in filtrate)

ammonia (become amonium ion once combined with H+ and is excreted)

36
Q

Where is HPO4- filtered?

A

Glomerulus , some of it remains for buffering

37
Q

What are the two things that are excreted by the kidneys(thereby excreting H+ ions)

A

Ammonium ion and monobasic phosphate

38
Q

What converts H2CO3 into H+ and HCO3- in renal buffering?

A

Carbonic anhydrase

39
Q

How is H2CO3 created?

A

CO2 and H2O combine

40
Q

If an individual in metabolic acidosis still have a normal anion gap what must be happening?

A

They are losing bicarbonate, gaining chloride

Hyperchloremic metabolic acidosis

41
Q

If the anion gap is elevated in an individual with metabolic acidosis- what does that mean?

A

Accumulation of an anion other than chloride

42
Q

What are things that lead to an increased non-carbonic acids (elevated anion gap)?

A

Ketoacidosis

Lactic acidosis

Ingestions

43
Q

What can lead to decreaesd H+ excretion?

A

Uremia

Distal renal tubule acidosis

44
Q

What can cause bicarbonate loss (normal anion gap)?

A

Diarrhea

Ureterosigmoidoscopy

Renal failure

Proximal renal tubule acidosis

45
Q

What type respirations are associated with metabolic acidosis?

A

Kussmaul respirations (very deep, very rapid respirations)

46
Q

What causes metabolic alkalosis (bicarb change)?

A

Bicarbonate increases

Usually due to excessive loss of meatbolic acids

47
Q

What causes metabolic alkalosis?

A

Prolonged vomiting

Gi sunctioning

Excessive intake of bicarbonate (Tums)

48
Q

What happens with vomiting with depletion of ECF and chloride

A

Hypochloremic metabolic alkalosis

49
Q

How do the kidneys make hypocholermic metabolic alkalosis worse? Why do they do this?

A

By increasing sodium and bicarbonate

Increase sodium because they want to maintain water concentration

Bicarb is retained to keep proper charge balance (because Cl- is being lost through vomitting)

50
Q

How do you correct Hypocholermic metabolic alkalosis?

A

Expand ECF with NaCl solution with K+

(K+ has been depleted because it is needed to move Na back into the body)

51
Q

What is Hyperaldosteronism?

A

sodium retention and loss of H+ and K+

There is a mild volume expansion with bicarb retention

52
Q

How would your body compensate for metabolic alkalosis?

A

Hypoventilation

53
Q

Do diuretics helps with bicarb excretion?

A

No- enchance Na+ K+ and Cl- excretion more than bicarb

54
Q

What are common symptoms of metabolic alkalosis?

A

Weakness

Muscle cramps

Hyperactive reflexes

55
Q

What is the pH for metabolic alkalosis?

A

pH >7.45

56
Q

When does respiratory acidosis occur?

A

Ventilation is depressed, CO2 is reatined

57
Q

What is hypercapnia?

A

An excess of CO2

58
Q

With acute uncompensated respiratory acidosis what happens to pH, PCO2 and bicarb?

A

Decreased pH

Elevated PCO2

Normal or slightly elevated bicarbonate

59
Q

Where is a chronic form of respiratory acidosis seen?

A

COPD - in this case renal compensation will be effective

serum bicarb and arterial PCO2 elevated- pH restored to normal

60
Q

What are common symptoms or respiratory acidosis?

A

Headache, restlessness, blurred vision

lethargy, muscle twitches, tremors

61
Q

If a person is in chronic respiratory acidosis, what will bicarb levels be?

What about acute?

A

Elevated

Normal with acute

62
Q

What is respiratory alkalosis due to?

A

Alveolar hyperventilation and excessive redution of CO2 (hypocapnia)

63
Q

What are symptoms of respiratory alkalosis?

A

Dizziness, confusion, parasthesias, convulsions, coma

Deep, rapid, respirations (tachypnea)

64
Q

In respiratory alkalsosis what is arterial pH?

What about PCO2?

A

arterial pH >7.45

PCO2 is decreased

65
Q

In acute respiratory alkalosis what do [bicarbonate] look like? What about chronic?

A

Acute- bicarb is normal

Chronic- bicarb is decreased

Medical Phys II (16 decks)

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