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Physiology Block 7 > Acid Base Physiology > Flashcards

Acid Base Physiology Flashcards

1
Q

Increased pH means what for H+ ions

A

Decreased

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2
Q

Decreased pH means what for H+ ions

A

Increased

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3
Q

Acidosis

A

Low body pH

Too much acid/not enough base

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4
Q

Alkalosis

A

High body pH

-too little acid/too much base

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5
Q

What is acid a product of

A

Cellular metabolism

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6
Q

What is the only volatile acid

A

CO2

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7
Q

What is volatile acid a product of

A

Aerobic metabolism

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8
Q

What are fixed acids

A

Products of protein, anaerobic or pathological metabolisms

  • sulfuric and phosphoric acid, proteins
  • lactic acid, ketoacidosis-hypoxia and diabetes
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9
Q

What is the range of pH in blood

A

7.35-7.45

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10
Q

How does the blood keep its pH balanced

A

Buffers

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11
Q

Weak acids/bases that can soak up extra acid or base and keep pH stable

A

Buffers

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12
Q

What is the most important ECF buffers

A

Bicarbonate

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13
Q

What are some other ECF buffers other than bicarbonate

A

Phosphoric acid in urine, proteins (albumin)

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14
Q

What are some ICF buffers

A

Organic phosphates and proteins (hemoglobin)

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15
Q

What does hemoglobin do to the ICF

A

Buffers

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16
Q

What is the primary buffer system in the body

A

Bicarbonate buffer system

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17
Q

Why is bicarbonate the most utilized buffer system in the body

A

Because of carbonic anhydrase

-takes CO2 and water and makes bicarbonate and acid

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18
Q

What is meant by the bicarbonate buffer system being an open system

A

CO2 is volatile

Levels can be easy changed by the lungs

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19
Q

What does changing PCO2 levels do to pH

A

Changes it

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20
Q

What are the two things kidneys do to manage acid-base

A

Reabsorbs filtered bicarbonate and secretes acid into urine

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21
Q

What does reabsorbing filtered HCO3- require

A

Carbonic anhydrase

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22
Q

Where is bicarbonate reabsorbed int he kidneys

A

PCT and collecting ducts

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23
Q

What does the kidney secrete acid as into the urine

A

NH4+ and H2PO4

-cant diffuse them out of the urine once they become this

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24
Q

What happens to bicarbonate when acid is secreted

A

Whenever acid is excreted, “new” bicarbonate is formed and reabsorbed

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25
Q

If you secrete acid, what must happen to bicarbonate?

A

Reabsorb it

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26
Q

What happens if there is excess HCO3- in plasma

A

It cannot all be absorbed and will be lost in urine

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27
Q

What does volume expansion of ECF do to bicarbonate

A

Inhibit bicarbonate reabsorption

  • peritubular capillary flow will be too high
  • stuff moving through kidney too fast
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28
Q

AngII and bicarbonate reabsorption

A

Increases bicarbonate reabsorption

  • contraction alkalosis
  • volume too low, more AngII, mroe reabsorbed bicarbonate
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29
Q

What causes contraction alkalosis

A

AngII

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30
Q

Why does AngII increase HCO3 reabsorption

A

AngII constricts efferent arterioles in the kidneys which slows renal blood flow, which allows more time to reabsorb

31
Q

What produces the H2PO4 and HPO4 buffering system

A

Type A intercalated cells in the CD (A=acid)

32
Q

Type A cells secreting H+ does what

A

Combine with filtered HPO4 to form H2PO4 and is excreted, this allows it to cross the membrane.

New bicarbonate is formed and reabsorbed too

33
Q

How is ammonium made

A

Breakdown of glutamine to make ammonia

-in the PCT and type A cells

34
Q

Excretion of NH4+

A

Glutamine broken down into ammonia (NH3) and secreted with H+ to make NH4+, this gets secreted and a bicarbonate gets reabsorbed

35
Q

What are the two different types of acid-base disorder categories

A

Respiratory acidosis/alkalosis and metabolic acidosis/alkalosis

36
Q

What is respiratory acidosis/alkalosis due to

A

Altered pH due to altered PCO2

37
Q

What is metabolic acidosis/alkalosis due to

A

Altered pH due to altered H+ production (metabolism) or HCO3- levels

38
Q

What kind of ventilation can cause respiratory acidosis

A

Hypoventilation

39
Q

What happens to PCO2 during repiratory acidosis

A

Increases

40
Q

What happens to pH during repspiratory acidosis

A

Decreases

41
Q

What does the kidney do to compensate for respiratory acidosis

A

Bicarbonate reabsorption and H+ excretion to compensate by not for at least 24 hours

42
Q

What kind of ventilation causes respiratory alkalosis

A

Hyperventilation

43
Q

What happens to PCO2 during respiratory alkalosis

A

Decreases

44
Q

What happens to pH during respiratory alkalosis

A

Increases

45
Q

How does kidney compensate for respiratory alkalosis

A

Bicarbonate excretion or H reabsorption by kidney but not for 24 hours

46
Q

What is metabolic acidosis caused by

A

Reduced HCO3- levels in plasma

47
Q

What would cause a reduction in HCO3- that would lead to metabolic acidosis

A

-Gain of H+ (decrease pH)

48
Q

What kind of breathing would you need to do to compensate for metabolic acidosis

A

Hyperventilate

-lowers PCO2 to compensate

49
Q

How does the kidney compensate for metabolic acidosis

A

HCO3- reabsorption and H+ excretion

50
Q

What is metabolic acidosis caused by

A

Diabetic ketoacidosis (increased acid production) or Diarrhea ( loss of HCO3-)

51
Q

What is metabolic alkalosis caused by

A

HCO3- levels in plasma

52
Q

What would a loss of H+ (increased pH) causes

A

Metabolic alkalosis

53
Q

What kind of breathing would you do to compensate for metabolic alkalosis

A

hypoventilate

Increase PCO2 to compensate

54
Q

What kind of breathing would you want to do if you wanted to increase PCO2?

A

Hypoventilate

55
Q

What kind of breathing would you want to do if you wanted your PCO2 levels to drop

A

Hyperventilate

56
Q

What do the kidneys do to compensate for metabolic alkalosis

A

HCO3- excretion and H+ reabsorption

57
Q

What kind of things can cause metabolic alkalosis

A

Either loss of acid (vomitting) or overproduction of HCO3- (eating too many tums and having renal failure)

58
Q

Acid-base and potassium balance

A

Because of renal handling of H+ and HCO3-, K+ levels are linked to pH levels

59
Q

How do K+ and H+ move together

A

In opposite directions

60
Q

What must you be carful about when treating someone for acidosis

A

Have to carefully monitor K+ levels due to rebound hypokalemia

61
Q

What does alkalosis do to potassium

A

Cause K+ to shift into cells

62
Q

What is H+ normally buffered by

A

Hemoglobin

63
Q

Why does alkalosis causes K+ to shift into cells

A

Because H+ is normally buffered by hemoglobin, loss of that charge pulls more K+ into ICF

64
Q

Where does K+ get pulled into the ICF?

A

DCT

65
Q

What happens when the K+ is being pulled into the ICF in the DCT during alkalosis

A

There is more to diffuse into the tubular fluid, since we need mroe H+ ions, we will absorb more H+ ions and K+ will be secreted (since they move in opposite directions)

This leads to increased K+ secretion with worsening hypokalemia

66
Q

Acute acidosis

A
  • happens in less than 24 hours
  • directly affects DCT and CD
  • affects cellular metabolism
67
Q

Acute acidosis’ affect on cellular metabolism

A

-less ATP, less ATPase activity, more ECF K+

68
Q

What happens to the apical K+ permeability in acute acidosis

A

Decreases it

  • less K+ secretion into urine
  • more K+ to leak back into blood
  • causes hyperkalemia as K+ leaves cells an collects in blood
69
Q

Alkalosis or acidosis causes hypokalemia?

A

Alkalosis

70
Q

Alkalosis or acidosis causes hyperkalemia

A

Chronic acidosis

71
Q

In chronic acidosis, what eventually starts to happen over time

A

Aldosterone is secreted, this takes a longer time to work since it is a steroid

72
Q

Chronic acidosis

A
  • more than 24 hours
  • indirectly affects DCT and CD
  • aldosterone has been secreted
  • this causes increased K+ secretion
  • K+ excretion is exacerbated by osmotic diuretics in the PCT
  • hyperkalemia despite a negative K+ balance
73
Q

Why is there hyperkalemia in chronic acidosis despite there being a negative K+ balance

A
  • Acidosis makes it a harder to make ATP, less transport
  • further decreases blood volume and increases RAAS
  • hyperkalemia despite a negative K+ balance
74
Q

A patient is diagnosed with a metabolic acidosis. Which of the following is an appropriate compensation

A

Increase breathing rate

Physiology Block 7 (10 decks)

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