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Organ Systems- Renal > Acid Base Physiology > Flashcards

Acid Base Physiology Flashcards

1
Q

What are the golden rules of Acid Base Physiology ?

A
  1. PCO2 and HCO3 always change in the same direction
  2. The secondary physiologic compensatory mechanisms must be present. If not, its a mixed disorder
  3. The compensatory mechanisms never fully correct pH, they bring it back to normal. If they overcorrect it is a mixed disorder
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2
Q

Metabolic Acidosis, Describe the three main types of etiology

A

Reduced Bicarbonate: Caused by decreased renal acid excretion, Direct Bicarb loss in the urine or feces, ( Type 2 renal acidosis and Intestinal fistulas / Diarrhea ) Or increased acid generation (Lactic Acids and Keto acids)

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3
Q

What will type 1 renal tubular acidosis cause and how ?

A

Distal renal tubule acidosis has a defective H/ATPase

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4
Q

How will renal failure cause metabolic acidosis ?

A

It will decrease NH4 excretion which will cause acidosis by using up the bicarbonate.

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5
Q

What are the causes of respiratory acidosis ?

A

Induced hypercapnia
Buffering mechanisms that raise bicarbonate
Increased NH4 excretion causes generation of new bicarbonate

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6
Q

What more common causes will a H & P show you that will que you in to respiratory acidosis ?

A

COPD, Smoking, Chronic Muscle Myeopathy

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7
Q

What causes respiratory alkylosis ?

A

Reduced Carbon dioxide due to increased alveolar ventilation. ( Hyperventilation)

Buffering processes that lower plasma bicarbonate.

When kidneys reduce net acid excretion.

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8
Q

Most common cause of chronic alkylosis ?

A

Pregnancy

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9
Q

Chronic vomiting ?

A

This will cause a loss of H+ from the stomach bile. Inducing metabolic alkylosis

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10
Q

What will hyperaldosteronism cause ?

A

Excessive water reabsorption but aldosterone also induces H+ secretion which can cause metabolic alkylosis

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11
Q

How do Cl changes relate to Bicarb changes ?

A

They move in opposite directions.

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12
Q
  1. Bicarb is elevated what two diseases could this be ?

What would you do next ?

A

Metabolic alkylosis, or respiratory acidosis in the chronic phase when the kidney has compensated.

Examine the patient, is he throwing up or not breathing ect.

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13
Q

What is the bodies major adaptive response to an acid load ?

A

Ammonium Excretion

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14
Q

Is Na affected by acid base disorders ?

A

No, not directly

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15
Q

Is plasma Cl affected in acid base disorders ?

A

Yes, it is altered in all acid base disorders. Except in increased metabolic gap ionic disorders.

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16
Q

How is the body’s phosphate homeostasis maintained ?

A

By the excretion of dietary phosphate. This mechanism accounts for the excretion of 10 - 40 mEq of phosphate per day.

17
Q

What happens in the plasma when strong acids dissociate ?

A

The H+ is buffered by bicarbonate and the A- will be excreted in the urine or reabsorbed by the kidney.

18
Q

What happens when the anion is retained by the kidney ?

A

There will be an unmeasured anion concentration retained in the plasma. This is called an increased plasma anion gap.

19
Q

What is total CO2 measure ?

A

CO2 and bicarbonate, normally 25-26 and will exceeds plasma bicarb.

20
Q

Normal value for Bicarbonate ?

A

24 mEq

21
Q

What kind of buffering system are humans ?

A

Open systems

22
Q

[ pH ] H+ =

A

24 [ ( CO2 / HCO3 ) ]

23
Q

What is the easy way to convert pH to H+ concentration ?

A

[ H+ ] = 80 - pH decimal digits

24
Q

Normal pH ?

A

7.35 - 7.45

25
Q

Normal pCO2 ?

A

36 mmHg - 44 mmHg

26
Q

Normal HCO3-

A

22 - 26 mmHg

27
Q

Metabolic disorders affect ?

A

Bicarbonate levels

28
Q

Respiratory Disorders ?

A

Affect CO2 levels and there will be slight bicarbonate level changes

29
Q

What is the major urine buffer ?

A

Phosphate and Ammonia

30
Q

Low bicarbonate with normal anion gap, + Urine anion gap =

A

Renal Tubular Acidosis

31
Q

Low Bicarbonate with Raised Serum anion gap ?

A

Renal retention of A- after strong acid dissociation.

Lactic acidosis, diabetic acidosis, Alcoholic Keto-acidosis, Poisoning, Uremic acidosis

32
Q

Low bicarbonate level with a normal anion gap and a negative urine anion gap ?

A

Non renal wasting

Diahrrhea, External loss of pancreatic and billary secretions

33
Q

Urine anion gap measures ?

A

Urine Na + K - Cl

NH4+ levels in the Urine indirectly, When NH4 is excreted Cl will follow lowering the UAG

34
Q

Is Cl altered by acid base disorders ?

A

Yes

35
Q

Is Na altered by acid base disorders ?

A

No

36
Q

If Na is normal and Cl changes what is present ?

A

An acid base disorder

Organ Systems- Renal (17 decks)

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