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Study Decks > Kaplan Prep - Fluid and Electrolyte Balance - Problem Set 3 > Flashcards

Kaplan Prep - Fluid and Electrolyte Balance - Problem Set 3 Flashcards

1
Q

Why is the acid-base balance in the body important?

A

Operation of all proteins is dependent on the pH of the medium that they function in.

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2
Q

What is normal pH of intracellular fluid?

A

7.0

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3
Q

What is the normal pH of venous blood and interstitial fluid?

A

7.35

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4
Q

What is the normal pH of arterial blood?

A

7.4

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5
Q

Define alkalosis

A

When arterial blood pH exceeds 7.45

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6
Q

Define acidosis

A

When arterial blood pH drops below 7.35

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7
Q

Why do venous blood and interstitial fluid have a lower pH?

A

Because of acidic materials produced by cellular metabolism.

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8
Q

What 3 ways is blood acidity (pH) controlled?

A
  1. 3 fast acting chemical buffer systems
  2. Brain stem respiratory center
  3. Renal system
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9
Q

What is the pH of any system dependent on?

A

The concentration of free H+ present (likely due to the ionization of strong acids)

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10
Q

What effect does more H+ have on the pH of a system?

A

More H+ makes the system more acidic and lowers the pH

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11
Q

What do bases produce?

A

OH-

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12
Q

What effect does more OH- have on the pH of a system?

A

The OH- “uses up” (combines with) the H+ and lowers the concentration of H+ which increases the pH.

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13
Q

Why do weak acids not significantly contribute to the pH of a solution?

A

The H+ is tightly bound and cannot dissociate to become free H+

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14
Q

What are the 3 major chemical buffer systems of the body?

A
  1. bicarbonate system
  2. phosphate system
  3. protein system
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15
Q

Which system is the main buffer for the interstitial and plasma fluids?

A

bicarbonate system

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16
Q

Which system acts as a buffer for the urine and intracellular fluid?

A

phosphate system

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17
Q

Which system is the main buffer for the intracellular fluid?

A

protein system

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18
Q

What are chemical acid-base buffers composed of?

A
  1. a weak acid and its anion

2. a weak base and its cation

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19
Q

Give an example of a weak acid and its anion

A

H2CO3 (carbonic acid) and HCO3- (bicarbonate ion)

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20
Q

Give an example of a weak base and its cation

A

NH3 and NH4+

21
Q

How do the chemical acid-base buffer work?

A

The pairs act to minimize pH changes. One substance of the pair reacts with H+ to prevent a lowering of the pH. The other substance reacts with OH- to prevent the pH from rising.

22
Q

What is the form of CO2 that is transported in the blood plamsa?

A

HCO3- (bicarbonate)

23
Q

How does the respiratory center respond to a drop in blood pH?

A

It causes more CO2 to be removed. The H+ gets used up and the pH rises.

24
Q

How does the respiratory center respond to a rise in blood pH?

A

It causes a depression in the respiratory center which causes an accumulation of CO2. H+ is formed which causes a decrease in pH.

25
Q

What is the only organ that has the ability to remove (rather than just bind) acids and bases from the body?

A

Kidneys

26
Q

What is the major renal acid-base regulating process?

A

Excreting or reabsorbing bicarbonate ion

27
Q

What does renal excretion of bicarbonate result in?

A

Retention of H+

28
Q

What does renal absorption of bicarbonate result in?

A

Excretion of H+

29
Q

If the concentration of bicarbonate in the filtrate is diminished (used up to buffer the blood) in response to developing blood acidosis what must happen?

A

The H+ secreted into the filtrate must be buffered and excreted to avoid radical decrease in urine pH

30
Q

What are the 2 mechanisms to avoid a radical decrease in urine pH when bicarbonate is used up to buffer the blood?

A
  1. renal phosphate buffer

2. ammonia buffer system

31
Q

How does the renal phosphate buffer system work when bicarbonate is used up?

A

It employs monohydrogen phosphate (HPO4 -2) to bind the H+ as H2PO4- which is excreted in the urine

32
Q

How does the ammonia buffer system work when bicarbonate is used up?

A

It employs ammonia (NH3) to bind the H+ as NH4+ which is excreted in the urine

33
Q

What happens during alkalosis in the collecting duct?

A

Collecting duct intercalated cells secrete bicarbonate while simultaneously recovering H+ to lower pH of blood. Bicarbonate combines with H+ to form carbonic acid which is then secreted to the blood where it dissociates to form H+ and bicarbonate which lowers blood pH

34
Q

What are the 2 classifications of acidosis and alkalosis?

A 
Respiratory disorder (higher or lower CO2 pressure in blood)
Metabolic disorder (some other cause)
35
Q

What happens to the body in acidosis?

A

Central nervous system is markedly depressed causing coma and imminent death

36
Q

What happens to the body in alkalosis?

A

Nervous system is markedly excited causing extreme nervousness, muscle contraction, convulsion and death ususally due to cessation of breathing

37
Q

Respiratory acidosis is characterized by what and due to what?

A

Characterized by lower pH due to higher CO2 pressure

38
Q

What specifically causes the lower pH and the higher CO2 pressure in respiratory acidosis?

A

Shallow breathing or limited gas exchange usually due to cystic fibrosis, emphysema or pneumonia

39
Q

Respiratory alkalosis is characterized by what and due to what?

A

Characterized by higher pH and due to lower CO2 pressure

40
Q

What specifically causes the higher pH and the lower CO2 pressure in respiratory alkalosis?

A

Hyperventilation such as in the case of a panic attack

41
Q

Respiratory acidosis and alkalosis can cause the renal system to do what?

A

Renal system can attempt to correct the disorder (renal compensation)

42
Q

Metabolic acidosis is characterized by what and due to what?

A

Characterized by lower pH (with normal CO2 levels) due to lower bicarbonate concentration

43
Q

What specifically causes the lower pH and the lower bicarbonate concentration in metabolic acidosis?

A

Build up of acidic metabolic products such as acetic acid (alcohol overdose), lactic acid (exercise or shock), diabetic ketosis or loss of bicarbonate caused by extreme diarrhea

44
Q

Metabolic alkalosis is characterized by what and due to what?

A

Characterized by higher pH (with normal levels of CO2) due to higher bicarbonate concentration

45
Q

What specifically causes the higher pH and the higher bicarbonate concentration in metabolic alkalosis?

A

Vomiting (loss of acidic stomach contents), intake of excess antacids and constipation which caused abnormal reabsorption of bicarbonate

46
Q

Metabolic acidosis and alkalosis can cause the respiratory system to do what?

A

Respiratory system can attempt to correct acidosis or alkalosis (respiratory compensation)

47
Q

What is the normal blood serum levels for pH?

A

7.35 - 7.45

48
Q

What is the normal blood serum levels for pressure of CO2?

A

35 - 45 mm

49
Q

What is the normal blood serum levels for bicarbonate?

A

22 - 26 mEq/L

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