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Physiology > Exam 4 - Electrolytes 3 > Flashcards

Exam 4 - Electrolytes 3 Flashcards

1
Q

Hypoventilation

A

increases blood CO2 levels (person will become acidotic)

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2
Q

Hyperventilation

A

decreases blood CO2 levels (person will become alkalotic)

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3
Q

Increase CO2 and decreased pH

A

stimulate pulmonary ventilation

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4
Q

Increase pH

A

inhibits pulmonary ventilation

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5
Q

Renal control of pH

A
  • most powerful “buffer” system (but slow response)
  • allows for reabsorption of HCO3- into ECF
  • renal tubules secrete H+ into tubular fluid then excrete it in urine
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6
Q

H+ secretion

A
  • rate of H+ secretion INCREASES as body fluid pH DECREASES (as H+ increases) or as ALDOSTERONE LEVELS INCREASE
  • secretion of H+ inhibited when urine pH falls below 4.5
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7
Q

Tubular secretion of H+ continues only w/…?

A

only w/ a concentration gradient of H+ between tubule cells and tubular fluid
- if H+ concentration increases in tubular fluid (lowering pH to 4.5), secretion of H+ stops

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8
Q

Buffers in tubular fluid

A
  • bicarbonate system
  • phosphate system
  • ammonia
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9
Q

Acidosis

A

H+ diffuses into cells and drives K+ out, elevating K+ concentration in ECF(hyperkalemia)

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10
Q

Effect of acidosis

A

H+ buffered by protein in ICF thus causing membrane HYPERPOLARIZATION
- nerve and muscle cells are hard to stimulate (CNS depression may lead to death)

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11
Q

Alkalosis

A

H+ diffuses out of cells and K+ diffuses in

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12
Q

Effect of alkalosis

A
  • membranes become DEPOLARIZED

- nerves overstimulate muscles causing spasms, tetany, convulsions, respiratory paralysis

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13
Q

Respiratory acidosis and example

A

rate of alveolar ventilation balls behind CO2 production

EX: emphysema

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14
Q

Respiratory alkalosis and example

A

CO2 eliminated faster than it is produced

EX: hyperventilation

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15
Q

Metabolic acidosis

A
  • increased production of organic acids (lactic acid, ketones)
  • ingestion of acidic drugs (aspirin)
  • loss of base (chronic diarrhea, laxative overuse)
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16
Q

Metabolic alkalosis

A
  • overuse of bicarbonates (antacids)

- loss of acid (chronic vomiting)

17
Q

Process of diagnosing an acid-base imbalance

A
  1. Note whether the pH is high or low relative to the normal range (this tells you whether you have acidosis or alkalosis)
  2. Decide which value of pCO2 or HCO3- could cause the abnormality (this tells you whether you have a respiratory or metabolic problem)
  3. Look at the NON-CAUSATIVE VALUE and determine if it is appropriately compensating for the problem (this tells you whether r not you have more than one problem going on)
18
Q

Normal pH value

A

7.40

19
Q

Anything below 7.40

A

acidosis

20
Q

Anything above 7.40

A

alkalosis

21
Q

Normal pCO2 value

A

40

22
Q

pCO2 above 40

A
  • tends toward acidosis
  • causes low pH
  • neutralizes high pH
23
Q

pCO2 below 40

A
  • tends toward alkalosis
  • causes high pH
  • neutralizes low pH
24
Q

Normal HCO3- (bicarbonate) level

A

24

25
Q

High pH, high pCO2

A

metabolic alkalosis

26
Q

High pH, low pCO2

A

respiratory alkalosis

27
Q

Low pH, high pCO2

A

respiratory acidosis (HCO3- will be high because it’s moving in the right direction to try to compensate for the acidosis)

28
Q

Low pH, low pCO2, low HCO3-

A

metabolic acidosis (decreased HCO3- leads to acidosis)

29
Q

Metabolic causes are in the same direction as…

A

pH
increase pH, increase bicarb
decrease pH, decrease bicarb

30
Q

Compensation

A

when both pCO2 and HCO3- rise or fall together to maintain NEARLY NORMAL pH (between 7.35 and 7.45)

31
Q

Partial (inadequate) compensation

A

occurs when pCO2 and HCO3- levels rise or fall together but the pH REMAINS PRETTY ABNORMAL

32
Q

What does partial (inadequate) compensation tell you?

A
  • tells you that you have more than one problem on your hands
33
Q

EX:
pH = 7.44
pCO2 = 30
HCO3- = 18

A
  • alkalosis
  • respiratory
  • complete compensation
34
Q

Anion Gap =

A

Na - (Cl + HCO3-)

35
Q

non-anion gap acidosis

A

< or = 12

36
Q

positive anion gap acidosis

A

> 12

37
Q

MULEPAK (possibilities that lead to a positive anion gap acidosis)

A
  • Methanol
  • Uremia
  • Lactic acid
  • Ethylene glycol
  • Paraldehyde
  • Aspirin
  • Ketoacidosis

Physiology (13 decks)

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