EMS lectures 15,16,17,18 Flashcards
What is the total amount of CO2 produced a day?
25mol/day
What amount of unmetabolised acids are produced in a day
50mmol/day
What amount of plasma H+ is produced in a day
40nmol/L
What is normal pH
7.45-7.35
[H+] = 35-45nmol/l
What is the prinicple of the henderson hasselbalch equation
[H+] homeostatis needs balance of H+ production and regeneration of HCO3-
Sites of acid base metabolism
lungs, kidneys, gi tract, liver
what enters/exits cell during tissue gas exchange
O2 in
Co2 out
Cl- in and out
what causes a right shift on the O2, Hb dissociation curve
Increased
2,3diPG, H+, Temperature
what type of acid base metabolism occurs in the liver
lactate metabolism UREA synthesis (only site)
what occurs in severe liver failure
NH4+ toxicity
Metabolic alkalosis
lack of urea and H+ produced
What are the compensatory mechanisms for acidosis/alkalosis
Respiratory
Renal bicarb regeneration
hepatic ship between urea syntheis and ammonia excretion
What is metabolic acidosis
Increase H+ formation (acid ingestion)
Decrease renal H+ excretion
decrease bicarb
H+ up pO2 up
pCo2 Down
What is metabolic alkalosis
what are the consequences of metabolica alkalosis
causes?
Generation bicarb by gastric mucosa
Renal generation HCO3- in HYPOKALAEMIA
H+ down, pO2 down
pCO2 up
K+ in cells and urine
PO4 in cells
respiratory suppression
Vomiting, ectopic ACTH
what is respiratory Acidosis
Co2 retention
- poor ventilation, perfusion, lungdisease
H+ up, pCO2 up
pO2 DOWN
What is respiratory alkalosis
inc CO2 excretion
excessive ventilatoin
H+ down PCO2 down
pO2 UP
Causes of increased H+ formation
Ketoacidosis (diabetes, alcoholism)
Lactic acidosis
poisoning
inheritied organic acidosis
What is diabetic ketoacidosis
hyperglycaemia - osmotic diuresis
causes hyperketonemia - increased FFA
what is alcoholic ketoacidosis
NAD+ depletion (thiamine)
- thiamine deficiency
- increased glycolyisis for ATP
- keto-acids inc to counter hormones
VOMIT ALOT
define adaption
reversible change in cellular features due to environmental changes
What are the types of adaptive response
increased cellular activity
decreased cellular activity
change of morphological features
what is adaptive response to an increase of demand
hypertrophy
hyperplasia
what is the effect of subcellular hypertrophy/hyperplasia
increased drug metabolism due to increased organelles
What is atrophy
reduction of organ/tissue size due to decrease in cell size or number
What are the mechanisms for atrophy
decrease of individual cell volume
death of individual cell via apoptosis
What is INVOLUTION
death of indiviudal cells via apoptosis as a mechanism for adaption
define
agenesis
failure to form embryonic cell mass
define aplasia
failure to differnetiate into organ specific tissue
define dysplasia
failure to organise into tissues of organ
define hypoplasia
failure to grow to full size organ
what is meta plasia
transformation form one cell type to another
epithelium or mesenchymal tissue
physiological or pathological
What is dysplasia
earliest stage of neoplasia
irreversible
non invasive in situ disease
cytology of malignancy
