Acid/Base Normal/Pathophyisology

Question 1

What is a pH <7.35

Answer 1

Acidic

Question 2

What is a pH of >7.4

Answer 2

Basic

Question 3

what does pH=

Answer 3

-log 10 [H+]

Question 4

What is the most acidic body fluid?

Answer 4

Gastric Juices

Question 5

Is pancreateic fluid acidic or basic and why?

Answer 5

Basic- helps neutralizes chyme from stomach upon entering duodenum

Question 6

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

Answer 6

CO2

Question 7

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

Answer 7

Renal tubules

Question 8

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

Answer 8

Lungs

Question 9

What is lactic acid formed by?

Answer 9

Anaerobic respiration of glucose

Question 10

What is a buffer?

Answer 10

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

Work as weak acid and conjugate base

Question 11

Where are buffers located?

Answer 11

ICF and ECF

Question 12

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

Answer 12

H2CO3 (carbonic acid)

Question 13

What is the base in the bicarbonate buffer system?

Answer 13

Bicarbonate (HCO3-)

Question 14

As CO2 goes up or down, H2CO3….

Answer 14

does the same

Question 15

How do lungs decrease H2CO3?

Answer 15

by eliminating CO2

Question 16

What do kidneys do with bicarbonate?

Answer 16

Reabsorb or generate new

Question 17

If bicarbonate decreases, what happens to pH?

Answer 17

pH drops

Question 18

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

Answer 18

pH goes up

Question 19

What is compensation ?

Answer 19

Normal ratio

Abnormal values

Question 20

What is correction?

Answer 20

Values return to normal, uses the same system

Question 21

What is an example of protein buffering?

Answer 21

Hemoglobin

Question 22

What is arterial blood pH <7.4

Answer 22

Acidemia

Question 23

What is a systemic increase is [H+]

Answer 23

Acidosis

Question 24

What is arterial blood pH >7.45?

Answer 24

Alkalemia

Question 25

What is a systemic decrease in [H+]

Answer 25

Alkalosis

Question 26

What is the normal Pa CO2 range?

Answer 26

36-44 mm Hg

Question 27

What is the normal HCO3- range?

Answer 27

22-26 mEq/ L

Question 28

As [H+] increases what happens to pH?

Answer 28

decrease

Question 29

Why is urine acidic?

Answer 29

Excess hydrogen ions are shed through urine (5.0-6.0)

Question 30

Where does carbonic acid come from?

Answer 30

Co2

Question 31

What is the pK value?

Answer 31

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

Question 32

What is the Henderson-Hasselbalch Equation?

Answer 32

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

Question 33

What type of Hb is the better buffter?

Answer 33

unsaturated

Question 34

Where does renal buffering occur?

Answer 34

DCT and collecting ducts (some PCT)

Question 35

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

Answer 35

Dibasic phosphate (when combined turns into monobasic phosphate- stays in filtrate) ammonia (become amonium ion once combined with H+ and is excreted)

Question 36

Where is HPO4- filtered?

Answer 36

Glomerulus , some of it remains for buffering

Question 37

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

Answer 37

Ammonium ion and monobasic phosphate

Question 38

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

Answer 38

Carbonic anhydrase

Question 39

How is H2CO3 created?

Answer 39

CO2 and H2O combine

Question 40

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

Answer 40

They are losing bicarbonate, gaining chloride Hyperchloremic metabolic acidosis

Question 41

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

Answer 41

Accumulation of an anion other than chloride

Question 42

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

Answer 42

Ketoacidosis Lactic acidosis Ingestions

Question 43

What can lead to decreaesd H+ excretion?

Answer 43

Uremia Distal renal tubule acidosis

Question 44

What can cause bicarbonate loss (normal anion gap)?

Answer 44

Diarrhea Ureterosigmoidoscopy Renal failure Proximal renal tubule acidosis

Question 45

What type respirations are associated with metabolic acidosis?

Answer 45

Kussmaul respirations (very deep, very rapid respirations)

Question 46

What causes metabolic alkalosis (bicarb change)?

Answer 46

Bicarbonate increases Usually due to excessive loss of meatbolic acids

Question 47

What causes metabolic alkalosis?

Answer 47

Prolonged vomiting Gi sunctioning Excessive intake of bicarbonate (Tums)

Question 48

What happens with vomiting with depletion of ECF and chloride

Answer 48

Hypochloremic metabolic alkalosis

Question 49

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

Answer 49

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)

Question 50

How do you correct Hypocholermic metabolic alkalosis?

Answer 50

Expand ECF with NaCl solution with K+ (K+ has been depleted because it is needed to move Na back into the body)

Question 51

What is Hyperaldosteronism?

Answer 51

sodium retention and loss of H+ and K+ There is a mild volume expansion with bicarb retention

Question 52

How would your body compensate for metabolic alkalosis?

Answer 52

Hypoventilation

Question 53

Do diuretics helps with bicarb excretion?

Answer 53

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

Question 54

What are common symptoms of metabolic alkalosis?

Answer 54

Weakness Muscle cramps Hyperactive reflexes

Question 55

What is the pH for metabolic alkalosis?

Answer 55

pH \>7.45

Question 56

When does respiratory acidosis occur?

Answer 56

Ventilation is depressed, CO2 is reatined

Question 57

What is hypercapnia?

Answer 57

An excess of CO2

Question 58

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

Answer 58

Decreased pH Elevated PCO2 Normal or slightly elevated bicarbonate

Question 59

Where is a chronic form of respiratory acidosis seen?

Answer 59

COPD - in this case renal compensation will be effective serum bicarb and arterial PCO2 elevated- pH restored to normal

Question 60

What are common symptoms or respiratory acidosis?

Answer 60

Headache, restlessness, blurred vision lethargy, muscle twitches, tremors

Question 61

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

Answer 61

Elevated Normal with acute

Question 62

What is respiratory alkalosis due to?

Answer 62

Alveolar hyperventilation and excessive redution of CO2 (hypocapnia)

Question 63

What are symptoms of respiratory alkalosis?

Answer 63

Dizziness, confusion, parasthesias, convulsions, coma Deep, rapid, respirations (tachypnea)

Question 64

In respiratory alkalsosis what is arterial pH? What about PCO2?

Answer 64

arterial pH \>7.45 PCO2 is decreased

Question 65

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

Answer 65

Acute- bicarb is normal Chronic- bicarb is decreased