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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
If you secrete acid, what must happen to bicarbonate?
Reabsorb it
26
What happens if there is excess HCO3- in plasma
It cannot all be absorbed and will be lost in urine
27
What does volume expansion of ECF do to bicarbonate
Inhibit bicarbonate reabsorption - peritubular capillary flow will be too high - stuff moving through kidney too fast
28
AngII and bicarbonate reabsorption
Increases bicarbonate reabsorption - contraction alkalosis - volume too low, more AngII, mroe reabsorbed bicarbonate
29
What causes contraction alkalosis
AngII
30
Why does AngII increase HCO3 reabsorption
AngII constricts efferent arterioles in the kidneys which slows renal blood flow, which allows more time to reabsorb
31
What produces the H2PO4 and HPO4 buffering system
Type A intercalated cells in the CD (A=acid)
32
Type A cells secreting H+ does what
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
How is ammonium made
Breakdown of glutamine to make ammonia | -in the PCT and type A cells
34
Excretion of NH4+
Glutamine broken down into ammonia (NH3) and secreted with H+ to make NH4+, this gets secreted and a bicarbonate gets reabsorbed
35
What are the two different types of acid-base disorder categories
Respiratory acidosis/alkalosis and metabolic acidosis/alkalosis
36
What is respiratory acidosis/alkalosis due to
Altered pH due to altered PCO2
37
What is metabolic acidosis/alkalosis due to
Altered pH due to altered H+ production (metabolism) or HCO3- levels
38
What kind of ventilation can cause respiratory acidosis
Hypoventilation
39
What happens to PCO2 during repiratory acidosis
Increases
40
What happens to pH during repspiratory acidosis
Decreases
41
What does the kidney do to compensate for respiratory acidosis
Bicarbonate reabsorption and H+ excretion to compensate by not for at least 24 hours
42
What kind of ventilation causes respiratory alkalosis
Hyperventilation
43
What happens to PCO2 during respiratory alkalosis
Decreases
44
What happens to pH during respiratory alkalosis
Increases
45
How does kidney compensate for respiratory alkalosis
Bicarbonate excretion or H reabsorption by kidney but not for 24 hours
46
What is metabolic acidosis caused by
Reduced HCO3- levels in plasma
47
What would cause a reduction in HCO3- that would lead to metabolic acidosis
-Gain of H+ (decrease pH)
48
What kind of breathing would you need to do to compensate for metabolic acidosis
Hyperventilate | -lowers PCO2 to compensate
49
How does the kidney compensate for metabolic acidosis
HCO3- reabsorption and H+ excretion
50
What is metabolic acidosis caused by
Diabetic ketoacidosis (increased acid production) or Diarrhea ( loss of HCO3-)
51
What is metabolic alkalosis caused by
HCO3- levels in plasma
52
What would a loss of H+ (increased pH) causes
Metabolic alkalosis
53
What kind of breathing would you do to compensate for metabolic alkalosis
hypoventilate | Increase PCO2 to compensate
54
What kind of breathing would you want to do if you wanted to increase PCO2?
Hypoventilate
55
What kind of breathing would you want to do if you wanted your PCO2 levels to drop
Hyperventilate
56
What do the kidneys do to compensate for metabolic alkalosis
HCO3- excretion and H+ reabsorption
57
What kind of things can cause metabolic alkalosis
Either loss of acid (vomitting) or overproduction of HCO3- (eating too many tums and having renal failure)
58
Acid-base and potassium balance
Because of renal handling of H+ and HCO3-, K+ levels are linked to pH levels
59
How do K+ and H+ move together
In opposite directions
60
What must you be carful about when treating someone for acidosis
Have to carefully monitor K+ levels due to rebound hypokalemia
61
What does alkalosis do to potassium
Cause K+ to shift into cells
62
What is H+ normally buffered by
Hemoglobin
63
Why does alkalosis causes K+ to shift into cells
Because H+ is normally buffered by hemoglobin, loss of that charge pulls more K+ into ICF
64
Where does K+ get pulled into the ICF?
DCT
65
What happens when the K+ is being pulled into the ICF in the DCT during alkalosis
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
Acute acidosis
- happens in less than 24 hours - directly affects DCT and CD - affects cellular metabolism
67
Acute acidosis' affect on cellular metabolism
-less ATP, less ATPase activity, more ECF K+
68
What happens to the apical K+ permeability in acute acidosis
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
Alkalosis or acidosis causes hypokalemia?
Alkalosis
70
Alkalosis or acidosis causes hyperkalemia
Chronic acidosis
71
In chronic acidosis, what eventually starts to happen over time
Aldosterone is secreted, this takes a longer time to work since it is a steroid
72
Chronic acidosis
- 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
Why is there hyperkalemia in chronic acidosis despite there being a negative K+ balance
- Acidosis makes it a harder to make ATP, less transport - further decreases blood volume and increases RAAS - hyperkalemia despite a negative K+ balance
74
A patient is diagnosed with a metabolic acidosis. Which of the following is an appropriate compensation
Increase breathing rate

Physiology Block 7 (10 decks)

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