LAST LECTURE!

Question 1

Describe the reabsorption filtered HCO3

Answer 1

1. H+ goes in to the lumen with the help of the Na/H exchanger
2. H+ combines with HCO3 to form H2CO3
3. CA turns it into H2O and CO2
4. CO2 diffuses back into cell and turns back into H2CO3 with the help of CA
5. dissociates
6. HCO3 goes into blood and H+ goes back into lumen

Question 2

Acetazolamide role?

Answer 2

inhibits the conversion of CO2 into H2CO3 by carbonic anhydrase

Question 3

formation of new HCO3 with phosphate buffer

Answer 3

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

Question 4

formation of new HCO3 with ammonia

Answer 4

1. H2CO3 is broken down into H+ and HCO3 by CA
2. H+ goes into lumen and HCO3 goes into blood
3. Glutamine is broken down into NH3 by glutaminase
4. NH3 and H+ combine in lumen to form NH4
5. excreted as NH4Cl

alpha- intercalated cell

Question 5

Diff between ammonia and phosphate buffer

Answer 5

ammonia is unlimited

highly stimulated during acidosis

Question 6

Beta-intercalated cells???

Answer 6

have a protein named pendrin that secretes HCO3 and pulls Cl into the cell

H+ is reabsorbed by H ATPase

active during chronic alkalosis

Question 7

Potassium during metabolic alkalosis and acidosis?

Answer 7

metabolic acidosis = high K

metabolic alkalosis = low K

Question 8

DM and K?

Answer 8

those with DM are seen to have high levels of K

due to insulin deficiency and hyperglycemia

Question 9

Hypokalemia and alkalosis?

Answer 9

Low K levels lead to an increase in H+ into the cells

leads to H+ excretion into the lumen

Question 10

Primary Hyperaldosteronism or Conn Syndrome

Answer 10

1. Hypertension (more reabsorption of Na)
2. hypokalemia (K excretion into urine)
3. alkalosis (stimulates H+ ATPase)

Question 11

Acute Respiratory acidosis

Answer 11

pH will be low

PCO2 = high

HCO3 = normal

Question 12

Chronic Respiratory acidosis

Answer 12

pH is low but closer to normal

PCO2 is high

HCO3 is high (kidney compensation)

Question 13

Acute respiratory alkalosis

Answer 13

pH is high

PCO2 = low

HCO3 = normal

Question 14

Chronic respiratory alkalosis

Answer 14

pH is high but closer to normal

PCO2 = low

HCO3 = low (renal compensation)

Question 15

Metabolic acidosis?

Answer 15

pH is low

PCO2 is low

HCO3 is low

hyperventilation will decrease PCO2 (compensate)

Question 16

Diabetic ketoacidosis

Answer 16

serum K is high
plasma glucose is high
insulin is low

treatment: insulin
serum K will drop

Question 17

anion gap equation?

Answer 17

Na - (Cl + HCO3)

Question 18

Metabolic alkalosis

Answer 18

pH is high
PCO2 is high
HCO3 is high

hypoventilation is to compensate

Question 19

what causes respiratory acidosis

Answer 19

drugs that inhibit respiration 
injury to phrenic nerve 
lung diseases 
foreign object in tract 
demyelinating diseases

Question 20

what causes respiratory alkalosis

Answer 20

hyperventilation
high altitude
mechanical ventilation
aspirin poisoning

Question 21

causes of metabolic acidosis

Answer 21

diabetic ketoacidosis
lactic acidosis
diarrhea

Question 22

causes of metabolic alkalosis

Answer 22

vomiting
hypokalemia
diuretics
conn syndrome