LAST LECTURE! Flashcards
Describe the reabsorption filtered HCO3
- H+ goes in to the lumen with the help of the Na/H exchanger
- H+ combines with HCO3 to form H2CO3
- CA turns it into H2O and CO2
- CO2 diffuses back into cell and turns back into H2CO3 with the help of CA
- dissociates
- HCO3 goes into blood and H+ goes back into lumen
Acetazolamide role?
inhibits the conversion of CO2 into H2CO3 by carbonic anhydrase
formation of new HCO3 with phosphate buffer
when the H+ goes into the lumen it combines with HPO4 to produce H2PO4
for every H+ excreted, one HCO3 goes into the blood
alpha-intercalated cell
formation of new HCO3 with ammonia
- H2CO3 is broken down into H+ and HCO3 by CA
- H+ goes into lumen and HCO3 goes into blood
- Glutamine is broken down into NH3 by glutaminase
- NH3 and H+ combine in lumen to form NH4
- excreted as NH4Cl
alpha- intercalated cell
Diff between ammonia and phosphate buffer
ammonia is unlimited
highly stimulated during acidosis
Beta-intercalated cells???
have a protein named pendrin that secretes HCO3 and pulls Cl into the cell
H+ is reabsorbed by H ATPase
active during chronic alkalosis
Potassium during metabolic alkalosis and acidosis?
metabolic acidosis = high K
metabolic alkalosis = low K
DM and K?
those with DM are seen to have high levels of K
due to insulin deficiency and hyperglycemia
Hypokalemia and alkalosis?
Low K levels lead to an increase in H+ into the cells
leads to H+ excretion into the lumen
Primary Hyperaldosteronism or Conn Syndrome
- Hypertension (more reabsorption of Na)
- hypokalemia (K excretion into urine)
- alkalosis (stimulates H+ ATPase)
Acute Respiratory acidosis
pH will be low
PCO2 = high
HCO3 = normal
Chronic Respiratory acidosis
pH is low but closer to normal
PCO2 is high
HCO3 is high (kidney compensation)
Acute respiratory alkalosis
pH is high
PCO2 = low
HCO3 = normal
Chronic respiratory alkalosis
pH is high but closer to normal
PCO2 = low
HCO3 = low (renal compensation)
Metabolic acidosis?
pH is low
PCO2 is low
HCO3 is low
hyperventilation will decrease PCO2 (compensate)
Diabetic ketoacidosis
serum K is high
plasma glucose is high
insulin is low
treatment: insulin
serum K will drop
anion gap equation?
Na - (Cl + HCO3)
Metabolic alkalosis
pH is high
PCO2 is high
HCO3 is high
hypoventilation is to compensate
what causes respiratory acidosis
drugs that inhibit respiration injury to phrenic nerve lung diseases foreign object in tract demyelinating diseases
what causes respiratory alkalosis
hyperventilation
high altitude
mechanical ventilation
aspirin poisoning
causes of metabolic acidosis
diabetic ketoacidosis
lactic acidosis
diarrhea
causes of metabolic alkalosis
vomiting
hypokalemia
diuretics
conn syndrome
