Exam 3 - Acid/Bases Kania (not done) Flashcards
pH < _____ = acidosis
pH > _____ = alkalosis
< 7.35
> 7.45
carbonic acid/bicarb buffer system equation
H+ + HCO3- <-> H2CO3 <-> CO2 + H2O
pka of carbonic acid
a. 2.0
b. 6.1
c. 7.45
d. 9.8
b. 6.1
most of the carbonic acid in plasma is in the form of _______ _______ gas
carbon dioxide
normal PaCO2 blood gas value range
35-45 (remember 40)
normal HCO3 blood gas value range
22-26 mEq/L (remember 24)
which is FALSE about adverse CV of consequences of acidemia?
a. dec cardiac output
b. impairment of cardiac contractility
c. dec pulmonary vascular resistance and arrhythmias
c. dec pulmonary vascular resistance and arrhythmias (increase)
which is NOT an adverse metabolic consequence of acidemia?
a. insulin resistance
b. stimulation of anaerobic glycolysis
c. hyperkalemia
b. stimulation of anaerobic glycolysis (should be inhibition)
which is NOT an adverse consequence of acidemia?
a. coma/altered mental status
b. dec respiratory muscle strength
c. hypoventilation
d. dyspnea
c. hypoventilation (hyperventilation)
T or F: arrhythmias can happen in alkalemia or acidemia
T
which is NOT an adverse consequence of alkalemia?
a. dec coronary blood flow
b. arteriolar constriction
c. inc anginal threshold
d. stimulation of anaerobic glycolysis
e. dec cerebral blood flow
c. inc anginal threshold
acid generation from diet: ~___ mEq/kg/day of acid consumed per day; comes from oxidation of proteins and fats
~1 mEq/kg/day
Aerobic metabolism of glucose produces ____-____ mmol of CO2 each day
15-20K
_______ _______ produces lactic and pyruvic acid
a. anaerobic metabolism
b. triglyceride oxidation
a. anaerobic metabolism
_______ _______ produces acetoacetic acid and beta-hydroxybutyric acid
a. anaerobic metabolism
b. triglyceride oxidation
b. triglyceride oxidation
three standard mechanisms of acid regulation
-buffering
-renal regulation
-ventilatory regulation
3 main buffer types we talked about
bicarb (main one)
phosphate
protein
which buffer has rapid onset with intermediate capacity?
a. bicarb
b. phosphate
c. protein
a. bicarb
when acid is added to bicarb, large quantities of ____ can be exhaled very rapidly
CO2
which buffer has intermediate onset and capacity?
a. bicarb
b. phosphate
c. protein
b. phosphate
T or F: calcium phosphates in bone are easily accessible
F
which buffers are rapid onset, limited capacity?
a. bicarb
b. phosphate
c. protein
c. protein (ex. albumin/hemoglobin)
bicarb reabsorption mainly occurs where (~85-90%)?
proximal tubule
kidney two main purposes
-reabsorb filtered HCO3-
-excrete H+ ions released from nonvolatile acids
net effect of bicarb reabsorption
filtered HCO3- is reabsorbed without any net loss of H+
which is FALSE about carbonic anhydrase inhibitors?
a. inhibit activity of carbonic anhydrase
b. inc entry of CO2 and H2O
c. metabolic acidosis occurs with inc HCO3- excretion
b. inc entry of CO2 and H2O
H+ excretion takes place primarily in the _______ tubule
a. proximal
b. distal
b. distal
look up ammonium excretion vs titratable activity (page 8)
okay
ventilatory regulation
a. intermediate onset and capacity
b. rapid onset, intermediate capacity
c. slow onset, large capacity
d. rapid onset, large capacity
d. rapid onset, large capacity
which is FALSE about ventilatory regulation?
a. Chemoreceptors detect an increase in the PaCO2
and decrease the rate and depth of ventilation
b. rapid onset, large capacity
c. peripheral chemoreceptors in carotid arteries and aorta
d. central chemoreceptors in medulla
a. Chemoreceptors detect an increase in the PaCO2
and decrease the rate and depth of ventilation (inc rate and depth of ventilation)
hepatic regulation: oxidation of proteins generates what two molecules?
bicarb, ammonium
metabolic acidosis is characterized by
pH < ___
HCO3- < ___ mEq/L
pH < 7.35
HCO3- < 24
anion gap equation
anion gap = Na+ - (Cl- + HCO3-)
pathophysiology of non-ion gap acidosis (hyperchloremic acidosis): overall, there is a loss of plasma ____ replaced by ____
HCO3-
Cl-
Which GI condition is a common cause of non-anion gap acidosis due to bicarbonate loss?
A) Vomiting
B) Constipation
C) Diarrhea
D) Gastric reflux
C) Diarrhea
(can lose 5-10 L of fluid)
T or F: pancreatic fistulas/biliary damage can cause bicarb losses
T
Which of the following can cause Type II renal tubular acidosis (proximal)?
A) Hyperkalemia
B) Heavy metal toxicity
C) Hyperthyroidism
D) Hypoglycemia
B) Heavy Metal Toxicity
Secondary hyperaldosteronism in Type II renal tubular acidosis (proximal) results in:
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
B) Hypokalemia
type 1 renal tubule acidosis
a.
