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RUSVM Physiology II > Acid Base Physiology > Flashcards

Acid Base Physiology Flashcards

1
Q

Acid

A

Proton donor

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2
Q

Acidosis

A

Condition which causes an increase in [H+]

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3
Q

Acidemia

A

Presence of greater than normal [H+] in blood

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4
Q

Base

A

Proton acceptor

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5
Q

Alkalosis

A

Condition which causes a decrease in [H+]

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6
Q

Alkalemia

A

Presence of less than normal [H+] in blood

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7
Q

CO2 added to H2O is an ________

A

Acid

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8
Q

Explain the Law of Electrical Neutrality in regards to [HCO3-] and [H+]

A

Increase in [H+] = Increase in [HCO3-]

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9
Q

Capacity

A

Volume added to a volume

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10
Q

Acidic animal’s physical response to increased acidity of plasma

A

Release CO2 by panting

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11
Q

An increase of acid or base is more common

A

Acid

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12
Q

Organ that gets rid of the most acid

A

Lungs

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13
Q

Importance of maintaining acid-base balance

A

Protein structure is dependent on prevailing [H+]

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14
Q

Departure from normal [H+] has what influence on drugs?

A

Changes in the structures they bind to, but also because many drugs are acids or bases their ability to donate/accept H+ is altered

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15
Q

Domestic animals can withstand proton concentrations that are between__________ the homeostatic normal [H+]

A

1/3 and 3 times

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16
Q

At equilibrium, the concentrations of _____, ______ and _______ are constant

A

Water, Proton and Hydroxide

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17
Q

Keq=

A

Keq= [H+] [OH-] / [H2O]

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18
Q

[H2O] Constant = ______

A

55.6 M

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19
Q

Keq constant = ______

A

1.8x10^-16

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20
Q

pH =

A

-log10 [H+]

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21
Q

Strong Acid/Base

A

One that readily dissociates

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22
Q

Weak Acid/Base

A

One which does not readily dissociate

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23
Q

Titratable Acidity/ Alkalinity

A

Total amount of proton/ proton acceptor which may be obtained from or complexed by another substance

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24
Q

Dissociation constant, Ka

A

Relative strength of an acid or base

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25
Q

Ka = [H+] under what circumstances?

A

When protonated and dissociated species are present in equal concentrations

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26
Q

pK

A

pH at which protonated and dissociated species are present in equal concentrations

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27
Q

Buffer

A

Weak acid able to resist changes in pH in the face of addition or removal of H+ from a solution

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28
Q

Relationship between buffer and pK

A

Buffer does its best buffering at its pK because it exists abundantly in both the protonated and dissociated forms. Permitting it to donate or titrate H+

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29
Q

Henderson-Hasselbalch Equation

A

pH= pK + log10 [A-] / [HA]

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30
Q

______________ is the most important buffer in the body.

A

CO2 + H2O H2CO3 H+ + HCO3-

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31
Q

pH of plasma is _____.

A

7.4

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32
Q

In order for an animal to survive, its pH needs to be between__________.

A

6.9 and 8.0

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33
Q

Ratio of HCO3- : CO2 should be _______.

A

20:1

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34
Q

Most important phosphate buffer is _______.

A

HPO4 2-

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35
Q

Intracellular Buffers include:

A
  1. H+ + HPO4 2- H2PO4- 2. H+ + Protein HProtein 3. H+ + HCO3- H2CO3
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36
Q

Interstitium Buffers include:

A
  1. H+ + HCO3- H2CO3 2. H+ + HPO4 2- H2PO4- 3. H+ + Protein HProtein
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37
Q

CSF buffers include

A
  1. H+ + HCO3- H2CO3
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38
Q

Tubular Filtrate Buffers include:

A
  1. H+ + HCO3- H2CO3 2. H+ + HPO4 2- H2PO4- 3. H+ + NH3 NH4
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39
Q

Plasma Buffers include:

A
  1. H+ + HCO3- H2CO3 2. H+ + Protein HProtein 3. H+ + HPO4 2- H2PO4-
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40
Q

Carbonic acid is found ___________.

A

Carbonic acid is found in all bodily fluids.

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41
Q

Carbonic acid is found ___________.

A

Carbonic acid is found 6.1.

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42
Q

pH of most body fluids is between _______.

A

pH of most body fluids is between 7.0-7.4.

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43
Q

pH of venous plasma is __________.

A

pH of venous plasma is less than 7.4.

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44
Q

pH of arterial plasma is ___________.

A

pH of arterial plasma is greater than 7.4.

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45
Q

____________ cells and ___________ cells of the kidney are capable of raising plasma [HCO3-]

A

Proximal tubule cells and** alpha intercalated** cells of the kidney are capable of raising plasma [HCO3-]

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46
Q

The reaction which lowers H2CO3 is ___________________.

A

The reaction which lowers H2CO3 is H2CO3 <–> H2O + CO2.

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47
Q

At equilibrium, there are aproximately 400 or more ________ molecules per H2CO3.

A

At equilibrium, there are aproximately 400 or more **CO2 **molecules per H2CO3.

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48
Q

CO2 in aqueous solution is an ___________.

A

CO2 in aqueous solution is an acid.

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49
Q

Normal values of [HCO3-] is ___________ and P CO2 is ____________ in plasma.

A

Normal values of [HCO3-] is 24 mM and P CO2 is 40 mmHg in plasma.

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50
Q

Overall reactions which buffer plasma at pH 7.4 are __________________________.

A

Overall reactions which buffer plasma at pH 7.4 are

H+ + HCO3- <–>H2CO3 <–> H2O + CO2.

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51
Q

[HCO3-] / (0.03) P CO2 should equal _______ in plasma.

A

[HCO3-] / (0.03) P CO2 should equal 20 in plasma.

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52
Q

If [HCO3-] / (0.03) P CO2 is greater than 20, an ___________ is present resulting in _____________.

A

If [HCO3-] / (0.03) P CO2 is greater than 20, an alkalosis is present resulting in alkalemia.

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53
Q

If [HCO3-] / (0.03) P CO2 is less than 20, an ___________ is present resulting in _____________.

A

If [HCO3-] / (0.03) P CO2 is less than 20, an acidosis is present resulting in acidemia.

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54
Q

If [HCO3-] / (0.03) P CO2 is greater than 20 and there is no change in P CO2, a ___________ is present.

A

If [HCO3-] / (0.03) P CO2 is greater than 20 and there is no change in P CO2, a metabolic alkalosis is present.

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55
Q

If [HCO3-] / (0.03) P CO2 is greater than 20 and there is no change in [HCO3-], a ___________ is present.

A

If [HCO3-] / (0.03) P CO2 is greater than 20 and there is no change in [HCO3-], a respiratory alkalosis is present.

56
Q

If [HCO3-] / (0.03) P CO2 is less than 20 and there is no change in [HCO3-], a ___________ is present.

A

If [HCO3-] / (0.03) P CO2 is less than 20 and there is no change in [HCO3-], a respiratory acidosis is present.

57
Q

If [HCO3-] / (0.03) P CO2 is less than 20 and there is no change in P CO2, a ___________ is present.

A

If [HCO3-] / (0.03) P CO2 is less than 20 and there is no change in P CO2, a metabolic acidosis is present.

58
Q

H+ + HCO3- <—> H2CO3 <—> H2O + CO2 is the predominant buffer system because:

A
  1. [HCO3-] is relatively high
  2. CO2 can be exhaled for rapid corrections when pH does depart from normal
  3. Dissociated HCO3- and protonated CO2 forms can be regulated independently
59
Q

Total CO2 (T CO2) is ___________________. It equals _____________________.

A

Total CO2 (T CO2) is the sum of all the forms in which CO2 is transported in plasma/serum. It equals [HCO3-] + CO2 (dissolved) + [H2CO3].

60
Q

Total CO2 (mM) = _____________.

A

Total CO2 (mM) = [HCO3-] (mM) + 0.03 PCO2 (mmHg).

61
Q

Total CO2 (mM) = __________ mM

A

Total CO2 (mM) = 25.2 mM

62
Q

__________ and __________ are the organs which are responsible for the ultimate removal of excess acid and/ or base.

A

Kidneys and lungs are the organs which are responsible for the ultimate removal of excess acid and/ or base.

63
Q

When acid/base is added or removed at rates that exceed the rate of removal/addition by the lungs and kidney, as in disease states, an animal must ________________.

A

When acid/base is added or removed at rates that exceed the rate of removal/addition by the lungs and kidney, as in disease states, an animal must rely on other organs to immediately/temporarily buffer the excess/deficiency.

64
Q

Alterations in plasma pH may reflect changes in the abilities of the _____________ and ____________ systems to respond to altered production/ loss of H+ by cells.

A

Alterations in plasma pH may reflect changes in the abilities of the respiratory and renal systems to respond to altered production/ loss of H+ by cells.

65
Q

Acid production originates in _________ are a result of ___________.

A

Acid production originates in cells are a result of cellular metabolism.

66
Q

Buffers ____________agains the products of _________.

A

Buffers **protect the cell **against the products of its own metabolism.

67
Q

A cell must be able to increase/ decrease the export of ____________ as intracellular pH changes.

A

A cell must be able to increase/ decrease the export of H+ and or/base as intracellular pH changes.

68
Q

A well known acid extruder is the ___________.

A

A well known acid extruder is the Na+-H+ antiport.

_____________________________________

Utilizes inwardly-directed Na+ concentration gradient to export H+

69
Q

Best known acid loader is _____________.

A

Best known acid loader is HCO3- -Cl- Exchanger.

__________________________________________

Utilizes the inwardly-directed Cl- concentration gradient to export HCO3-

70
Q

Decreased intracellular pH results in increased activity of __________ and decreased activity of the _____________.

A

Intracellular pH results in increased activity of acid extruders, and decreased activity of the acid loaders.

71
Q

Decreased extracellular pH results in decreased activity of the ____________________ and increased activity of the _______________.

A

Decreased extracellular pH results in decreased activity of the acid extruders and increased activity of the acid loaders.

72
Q

Decreae in extrcellular pH cause by one group of cells will result in increased _______ retention and increased __________________ of H+ in other groups of cells.

A

Decreae in extrcellular pH cause by one group of cells will result in increased H+ retention and increased intracellular buffering of H+ in other groups of cells.

73
Q

Behavior of extruders in some cells is dependent on _____________________, _____________ and _______________..

A

Behavior of extruders in cells is dependent on interstitial, intracellular and luminal pH.

74
Q

____________ and ___________ are frequently used in the clinical assessment of overall acid-base status.

A

Anion Gap and Base Excess are frequently used in the clinical assessment of overall acid-base status.

75
Q

Number of negative charges __________the number of positive charges in all solutions.

A

Number of negative charges **equals **the number of positive charges in all solutions.

76
Q

Clinical measurement usually includes only the major cations and major anions, in plasma these are ____________________.

A

Clinical measurement usually includes only the major cations and major anions, in plasma these are Na+, K+, Cl- and HCO3-.

77
Q

Anion Gap

A

The difference between total anions and total cations in plasma

78
Q

Anion Gap = _________________.

A

Anion Gap = Counted Cations - Counted Anions

or

= Uncounted Cations - Uncounted Anions.

79
Q

Base Deficit

A

The amount of acid (base) that would restore 1L of blood to normal acid/base composition.

80
Q

Base Excess (deficit) is an indicator of overall _____________.

A

Base Excess (deficit) is an indicator of overall non-respiratory acid/base status.

81
Q

Base excess (deficit) is calculated from ___ and _____ usuing teh Siggaard-Anderson Nomogram.

A

Base excess (deficit) is calculated from P CO2 and pH usuing teh Siggaard-Anderson Nomogram.

82
Q

Base excess refers to blood rather than plasma and therefore includes the buffering ability of __________ in addition to the plasma HCO3-, protein and phosphate buffers.

A

Base excess refers to blood rather than plasma and therefore includes the buffering ability of hemoglobin in addition to the plasma HCO3-, protein and phosphate buffers.

83
Q

Contribution of hemoglobin buffer depends on both the __________ of and ______ of hemoglobin.

A

Contribution of hemoglobin buffer depends on both the concentration and pK of hemoglobin.

84
Q

Causes of metabolic acidiosis are related to conditions in which __________ is either added in excess or excreted poorly or ______ is lost excessively or reabsorbed poorly.

A

Causes of metabolic acidiosis are related to conditions in which H+ is either added in excess or excreted poorly or HCO3- is lost excessively or reabsorbed poorly.

85
Q

Titration acidosis

A

H+ is either added in excess or excreted poorly

86
Q

Bicarbonate-Losing Acidosis

A

HCO3- is lost excessively or reabsorbed poorly

87
Q

Common causes of metabolic acidosis:

A
  1. Renal Insufficiency
  2. Ketosis
  3. Hyperkalemia
  4. Pancreatic/Biliary Tract Obstruction
  5. Diarrhea
  6. Anaerobiosis/Ischemic Hypoxia
  7. Ingestion of Ethylene Glycol
88
Q

An increase in H+ during metabolic acidosis in plasma can be compensated for by ____________.

A

An increase in H+ during metabolic acidosis in plasma can be compensated for by increasing the loss of CO2.

89
Q

Respiratory compensation, while lowering ______ also lowers _______.

A

Respiratory compensation, while lowering [H+] also lowers [HCO3-].

90
Q

Extracellular buffering and intracellular buffering accompany respiratory compensation by:

A
  1. H+A- entering the cell
  2. H+A- catabolized by aerobic cells, resulting in CO2
  3. H+ “enters” the cell in exchange for K+
91
Q

Explain how H+ “enters” the cell in exchange for K+

A

Less H+ is pumped out of teh cell and presumably less ECF Na+ enters the cell, which decreases the amount of Na+ that can be pumped out of the cell by Na+-K+ ATPase. Less than the normal amount of K+ is pumped into the cell thereby promoting increased plasma [K+].

92
Q

Metabolic Acidosis can promote __________.

A

Metabolic Acidosis can promote hyperkalemia.

93
Q

Renal compensation for metabolic acidosis is to increase reabsorption of ______ at the ______.

A

Renal compensation for metabolic acidosis takes the form of increaed reabsorption of HCO3- at the PCT.

94
Q

Synthesis of HCO3- is accomplished through increased production of _______ obtained through the metabolism of ____________.

A

Synthesis of HCO3- is accomplished through increased production of CO2 obtained through the metabolism of glutamine.

95
Q

Glutamine is converted to ___________ and NH3 by _____________.

A

Glutamine is converted to glutamate and NH3 by glutaminase.

96
Q

Glutamate is converted to ____________ and NH3 which is either oxidized or converted to glucose, releasing a CO2 which is acted on by ____________ to produce __________ and H+.

A

Glutamate is converted to alpha ketoglutarate and NH3 which is either oxidized or converted to glucose, releasing a CO2 which is acted on by carbonic anhydrase to produce HCO3- and H+.

97
Q

Unbound secreted H+ by the PCT has the tendancy to ______________.

A

Unbound secreted H+ by the PCT has the tendancy to diffuse back thorugh tight junctions.

98
Q

Secreted H+ associates with secreted _______ to form _______ which does not allow passage through tight junctions.

A

Secreted H+ associates with secreted NH3 to form NH4+ which does not allow passage through tight junctions.

99
Q

Activity of the ______________ cells of teh DCT/CCD/MCD is critical to normal acid-base balance.

A

Activity of the alpha intercalated cells of teh DCT/CCD/MCD is critical to normal acid-base balance.

100
Q

Glutaminase activity is _____ dependent, increased ________ in the PCT leads to increased activity.

A

Glutaminase activity is pH dependent, increased acidity in the PCT leads to increased activity.

101
Q

Urea and Glutamate are synthesized by the __________.

A

Urea and Glutamate are synthesized by the liver.

102
Q

Metabolic acidosis is characterized by ________ plasma [H+], ________ [HCO3-] and ______ PCO2.

A

Metabolic acidosis is characterized by increased plasma [H+], **decreased **[HCO3-] and decreased PCO2.

103
Q

All causes of __________ are related to compromised respiratory function, resulting in hypoventilation and increased P CO2.

A

All causes of respiratory acidosis are related to compromised respiratory function, resulting in hypoventilation and increased P CO2.

104
Q

Common causes of respiratory acidosis:

A
  1. Pneumonitis/Pneumonia
  2. Pulmonary Edema
  3. Bronchoconstriction
  4. CNS Depression
  5. Pneumothorax, Hydrothorax, Hemothorax, Chylothorax
  6. Neurologic and Neuromuscluar Disorders
105
Q

Increased levels of ______ will result in the production of more H+ and HCO3- levels will increase as well.

A

Increased levels of CO2 will result in the production of more H+ and HCO3- levels will increase as well.

106
Q

Renal compensation of respiratory acidosis takes the form of increased H+ __________ and increased HCO3- __________ and synthesis secondary to increased generation and uptake of CO2.

A

Renal compensation of respiratory acidosis takes the form of increased H+ secretion and increased HCO3- reabsorption and synthesis secondary to increased generation and uptake of CO2.

107
Q

CO2 can cross all cell membranes, ___________ will experience an increase in intracellular H+ and HCO3-, including CNS chemoreceptors in respiratory acidosis.

A

CO2 can cross all cell membranes, all cells in the body will experience an increase in intracellular H+ and HCO3-, including CNS chemoreceptors in respiratory acidosis.

108
Q

Acid extruders are inhibted by _________ in respiratory acidosis.

A

Acid extruders are inhibted by decreased pH in respiratory acidosis.

109
Q

In respiratory acidosis, increased uptake of CO2 by _________ enables these cells to release more HCO3- in exchange for CL-

A

In respiratory acidosis, increased uptake of CO2 by Red Blood Cells enables these cells to release more HCO3- in exchange for CL-

110
Q

Respiratory acidosis is characterized by _______ plasma [H+], __________ [HCO3-] and _______ P CO2.

A

Respiratory acidosis is characterized by increased plasma [H+], increased [HCO3-] and increased P CO2.

111
Q

Metabolic alkalosis is related to conditions in which H+ is _______ excessively or HCO3- is _______ excessively to plasma.

A

Metabolic alkalosis is related to conditions in which H+ is lost excessively or HCO3- is added excessively to plasma.

112
Q

Common causes of Metabolic Alkalosis:

A
  1. Vomiting
  2. Abomasal volvulus
  3. Gastric Dilitation and Volvulus
  4. Hyperadrenocorticism
  5. Iatrogenic
113
Q

Renal compensation for metabolic alkalosis takes the form of decreased HCO3- __________, largely as a result of decreased ________ of H+ accompanied by decreased ___________ of NH3/NH4+.

A

Renal compensation for metabolic alkalosis takes the form of decreased HCO3- reabsorption, largely as a result of decreased secretion of H+ accompanied by decreased secretion of NH3/NH4+.

114
Q

Decreased HCO3- reabsorption results in increased ______________ in teh first half of the PCT in Metabolic Alkalosis.

A

Decreased HCO3- reabsorption results in increased Cl- reabsorption in teh first half of the PCT in Metabolic Alkalosis.

115
Q

Alkalosis increases luminal membrane K+ conductance and Na+-K+ ATPase activity which results in ______________________.

A

Alkalosis increases luminal membrane K+ conductance and Na+-K+ ATPase activity which results in K+ entering filtrate easily decreasing H+ entry into filtrate.

116
Q

___________ may develop as a result of the altered activities of principal cells and skeletal muscle cells in response to alkalosis.

A

Hypokalemia may develop as a result of the altered activities of principal cells and skeletal muscle cells in response to alkalosis.

117
Q

Renal compensation for metabolic alkalosis accompanied by dehydration is not as efficient as one might expect due to __________ and __________.

A

Renal compensation for metabolic alkalosis accompanied by dehydration is not as efficient as one might expect due to Angiotension II and Aldosterone.

118
Q

Angiotension II in response to dehydration promotes ___________ activity of basolateral Na+-K+ ATPase and of the luminal Na+-H+ antiport and basolateral Na+-HCO3- symport in PCT, thus _________ HCO3- reabsorption.

A

Angiotension II in response to dehydration promotes increases activity of basolateral Na+-K+ ATPase and of the luminal Na+-H+ antiport and basolateral Na+-HCO3- symport in PCT, thus** stimulating** HCO3- reabsorption.

119
Q

Aldosterone stimulated by dehydration stimulates __________ H+ secretion and therefore ________ HCO3- reabsorption in principal cells of the DCT/CCD/MCD.

A

Aldosterone stimulated by dehydration stimulates Increased H+ secretion and therefore increased HCO3- reabsorption in principal cells of the DCT/CCD/MCD.

120
Q

Abomasal voluvulus and GDV are examples of _______________.

A

Abomasal voluvulus and GDV are examples of mixed acid-base disorders.

121
Q

Explain how GDV and Abomasal Voluvulus are mixed acid-base disorders.

A

Volume of fluid that collects in the lumen of the abomasum may result in dehydration that can cause increased lactic acid production by poorly perfused organs. Dilation may be so pronounced that it causes compression of the caudal vena cava increasing perfusion problems as well as compressing the diaphragm resulting in respiratory acidosis.

122
Q

Metabolic Alkalosis is characterized by _______ plasma [H+], ___________ [HCO3-] and ___________ PCO2.

A

Metabolic Alkalosis is characterized by decreased plasma [H+], **increased ** [HCO3-] and increased PCO2.

123
Q

Causes of respiratory alkalosis related to _______________, resulting in hyperventilation and decreased ________.

A

Causes of respiratory alkalosis related to increased respiratory function, resulting in hyperventilation and decreased P CO2.

124
Q

Common causes of respiratory alkalosis include:

A
  1. CNS lesions
  2. CNS inflammation
  3. Pain
  4. Severe hypoxemia
125
Q

Renal compensation of respiratory alkalosis takes the for of decreased H+ __________ and decreased HCO3- _________.

A

Renal compensation of respiratory alkalosis takes the for of decreased H+ secretion and decreased HCO3- reabsorption.

126
Q

Decreased HCO3- __________ is accompanied by increased Cl- ____________.

A

Decreased HCO3- reabsorption is accompanied by increased Cl- reabsorption.

127
Q

Hyperventilation can ________ body fluids so rapidly that consciousness could be lost before renal compensation has noticible effect.

A

Hyperventilation can alkalinize body fluids so rapidly that consciousness could be lost before renal compensation has noticible effect.

128
Q

In hypoxemia, cellular producion of lactic acid that has what effect on alkalosis?

A

Decreases to some extent the alkalosis

129
Q

Respiratory alkalosis is characterized by ______ plasma [H+], _____ [HCO3-] and ________ P CO2.

A

Respiratory alkalosis is characterized by decreased plasma [H+], decreased [HCO3-] and decreased P CO2.

130
Q

Independent variables which altered, result in plasma changes of [Na+] and [HCO3-] are plasma __________, _________, __________, ___________, __________, ___________, and ___________.

A

Independent variables which altered, result in plasma changes of [Na+] and [HCO3-] are plasma [Na+], [Cl-], [lactate-], [acetoacetate-], [beta-hydroxybuterate-], [protein-], and [phosphate].

131
Q

Strong cations in plasma include ____, ____, ____ and _____.

A

Strong cations in plasma include Na+, K+, **Ca++ **and Mg++.

132
Q

Strong anions in plasma include ____, _____, ______, ______ and ______.

A

Strong anions in plasma include Cl-, SO4 2-, lactate-, acetoacetate- and beta-hydroxybuterate-.

133
Q

In plasma the sum of the concentrations of ___________ is greater than the sume of the concentrations of __________.

A

In plasma the sum of the concentrations of strong cations is greater than the sume of the concentrations of strong anions.

134
Q

Strong Ion Difference (SID)

A

Difference in the sum of strong anions and strong cations in plasma

135
Q

If SID is positive, [H+] must be ______ then [OH-] thus plasma is _________.

A

If SID is positive, [H+] must be less then [OH-] thus plasma is alkaline.

RUSVM Physiology II (7 decks)

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