Exam 3 - Acid/Bases Kania (not done)

Question 1

pH < _____ = acidosis
pH > _____ = alkalosis

Answer 1

< 7.35
> 7.45

Question 2

carbonic acid/bicarb buffer system equation

Answer 2

H+ + HCO3- <-> H2CO3 <-> CO2 + H2O

Question 3

pka of carbonic acid

a. 2.0
b. 6.1
c. 7.45
d. 9.8

Answer 3

b. 6.1

Question 4

most of the carbonic acid in plasma is in the form of _______ _______ gas

Answer 4

carbon dioxide

Question 5

normal PaCO2 blood gas value range

Answer 5

35-45 (remember 40)

Question 6

normal HCO3 blood gas value range

Answer 6

22-26 mEq/L (remember 24)

Question 7

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

Answer 7

c. dec pulmonary vascular resistance and arrhythmias (increase)

Question 8

which is NOT an adverse metabolic consequence of acidemia?

a. insulin resistance
b. stimulation of anaerobic glycolysis
c. hyperkalemia

Answer 8

b. stimulation of anaerobic glycolysis (should be inhibition)

Question 9

which is NOT an adverse consequence of acidemia?

a. coma/altered mental status
b. dec respiratory muscle strength
c. hypoventilation
d. dyspnea

Answer 9

c. hypoventilation (hyperventilation)

Question 10

T or F: arrhythmias can happen in alkalemia or acidemia

Answer 10

T

Question 11

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

Answer 11

c. inc anginal threshold

Question 12

acid generation from diet: ~___ mEq/kg/day of acid consumed per day; comes from oxidation of proteins and fats

Answer 12

~1 mEq/kg/day

Question 13

Aerobic metabolism of glucose produces ____-____ mmol of CO2 each day

Answer 13

15-20K

Question 14

_______ _______ produces lactic and pyruvic acid

a. anaerobic metabolism
b. triglyceride oxidation

Answer 14

a. anaerobic metabolism

Question 15

_______ _______ produces acetoacetic acid and beta-hydroxybutyric acid

a. anaerobic metabolism
b. triglyceride oxidation

Answer 15

b. triglyceride oxidation

Question 16

three standard mechanisms of acid regulation

Answer 16

-buffering
-renal regulation
-ventilatory regulation

Question 17

3 main buffer types we talked about

Answer 17

bicarb (main one)
phosphate
protein

Question 18

which buffer has rapid onset with intermediate capacity?

a. bicarb
b. phosphate
c. protein

Answer 18

a. bicarb

Question 19

when acid is added to bicarb, large quantities of ____ can be exhaled very rapidly

Answer 19

CO2

Question 20

which buffer has intermediate onset and capacity?

a. bicarb
b. phosphate
c. protein

Answer 20

b. phosphate

Question 21

T or F: calcium phosphates in bone are easily accessible

Answer 21

F

Question 22

which buffers are rapid onset, limited capacity?

a. bicarb
b. phosphate
c. protein

Answer 22

c. protein (ex. albumin/hemoglobin)

Question 23

bicarb reabsorption mainly occurs where (~85-90%)?

Answer 23

proximal tubule

Question 24

kidney two main purposes

Answer 24

-reabsorb filtered HCO3-
-excrete H+ ions released from nonvolatile acids

Question 25

net effect of bicarb reabsorption

Answer 25

filtered HCO3- is reabsorbed without any net loss of H+

Question 26

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

Answer 26

b. inc entry of CO2 and H2O

Question 27

H+ excretion takes place primarily in the _______ tubule

a. proximal
b. distal

Answer 27

b. distal

Question 28

look up ammonium excretion vs titratable activity (page 8)

Answer 28

okay

Question 29

ventilatory regulation

a. intermediate onset and capacity
b. rapid onset, intermediate capacity
c. slow onset, large capacity
d. rapid onset, large capacity

Answer 29

d. rapid onset, large capacity

Question 30

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

Answer 30

a. Chemoreceptors detect an increase in the PaCO2
and decrease the rate and depth of ventilation (inc rate and depth of ventilation)

Question 31

hepatic regulation: oxidation of proteins generates what two molecules?

Answer 31

bicarb, ammonium

Question 32

metabolic acidosis is characterized by

pH < ___
HCO3- < ___ mEq/L

Answer 32

pH < 7.35
HCO3- < 24

Question 33

anion gap equation

Answer 33

anion gap = Na+ - (Cl- + HCO3-)

Question 34

pathophysiology of non-ion gap acidosis (hyperchloremic acidosis): overall, there is a loss of plasma ____ replaced by ____

Answer 34

HCO3-
Cl-

Question 35

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

Answer 35

C) Diarrhea

(can lose 5-10 L of fluid)

Question 36

T or F: pancreatic fistulas/biliary damage can cause bicarb losses

Answer 36

T

Question 37

Which of the following can cause Type II renal tubular acidosis (proximal)?

A) Hyperkalemia
B) Heavy metal toxicity
C) Hyperthyroidism
D) Hypoglycemia

Answer 37

B) Heavy Metal Toxicity

Question 38

Secondary hyperaldosteronism in Type II renal tubular acidosis (proximal) results in:

A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia

Answer 38

B) Hypokalemia

Question 39

type 1 renal tubule acidosis

a.