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BMS 334 (Histology) > Lecture 14 > Flashcards

Lecture 14 Flashcards

1
Q
A
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2
Q

Generally how is acid-base balance maintained in the body?

A

maintained by controlling the H+ concentration of body fluids, especially extracellular fluid.

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3
Q

Why is [H+] essential for homeostasis?

A
  • Proteins (including enzymes) 3-D structure sensitive to pH changes
    • pH declines 1 unit = Sodium-potassium pump decreases by half
    • pH declines 0.1 unit = Phosphofructo-kinase activity decreases by 90%
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4
Q

diet high in proteins tends to acidify or alkanize the blood

A

acidify

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5
Q

what is normal pH in blood?

A

7.35 - 7.45

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6
Q

Define

  1. Acidemia
  2. Acidosis
A
  1. Acidemia- increase in acidity of blood
  2. Acidosis- increase in acidity of tissues
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7
Q
  1. what pH is acidemia?
  2. alkalemia
A
  1. Acidemia = pH < 7.35
  2. Alkalemia = pH > 7.45
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8
Q

Define

  1. Alkalemia
  2. Alkalosis
A
  1. Alkalemia- increase in basicity in blood
  2. Alkalosis- increase in basicity in tissues
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9
Q

what will happen in acidosis generally?

A

Acidosis- Principal effect is depression of the central nervous system through depression of synaptic transmission. -> Coma

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10
Q

what will happen in alkalosis generally?

A

Alkalosis- Overexcitability of the central nervous system through facilitation of synaptic transmission. -> Seizures

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11
Q

what are 3 major mechanisms to regulate pH and generally how much time for each

A
  1. Buffer systems- Seconds
  2. Exhalation of CO2 -Minutes to hours
  3. Kidney excretion of H+ - Days
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12
Q
  1. what are the 3 buffer systems?
  2. what do they generally do?
A
  1. Protein buffer system,
    • carbonic acid-bicarbonate buffer system,
    • phosphate buffer system
  2. Prevent rapid, drastic changes in pH
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13
Q
  1. what does the protein buffer system do?
  2. Where is the protein buffer system found?
A
  1. Change either strong acid or base into weaker one
  2. Abundant in intracellular fluids and in plasma
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14
Q
  1. What is a good protein buffer in RBCs?
  2. plasma?
A
  1. hemoglobin very good at buffering H+ in RBCs
  2. albumin is main plasma protein buffer
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15
Q

regarding the protein buffer system

Amino acids contains at least one carboxyl group (-COOH) and at least one amino group (-NH2)

  • what will each group do?
A
  • carboxyl group acts like an acid and releases H+
  • amino group acts like a base and combines with H+
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16
Q

Regarding the protein buffer system

  • What acts as a buffer in blood by picking up CO2 or H+
A

Hemoglobin

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17
Q
  1. what does the carbonic acid-bicarbonate buffer system do?
A
  1. Acts as extracellular & intracellular buffer system
    • bicarbonate ion (HCO3-) can act as a weak base
      • holds excess H+
    • carbonic acid (H2CO3) can act as weak acid
      • dissociates into H+ ions
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18
Q

Regarding the carbonic acid-bicarbonate buffer system

  1. At a pH of 7.4, bicarbonate ion concentration is about __ times that of carbonic acid
  2. What is a limitation of this buffer system
A
  1. 20 times
  2. Cannot protect against pH changes due to respiratory problems
19
Q
  1. What does the phosphate buffer system do? (what 2 components)
  2. where is it located?
A
  1. Dihydrogen phosphate ion acts as a weak acid that can buffer a strong base
    • Monohydrogen phosphate acts a weak base by buffering the H+ released by a strong acid
  2. Most important intracellularly, but also acts to buffer acids in the urine
20
Q
  1. CO2 is an acid or base?
  2. what is CO2 a result of?
A
  1. Volatile acid – CO2
  2. Result of carbohydrate and fat metabolism
21
Q
  1. If PaCO2 is high what is the respiratory system currently doing
  2. low?
A
  1. high- Hypoventilation
  2. low- Hyperventilation
22
Q

How does the animal compensate if pH is low = Acidemia?

A
  1. Exhalation of Carbon Dioxide and
  2. Renal Excretion of H+ and Reabsorption of HCO3
23
Q

How does the animal’s respiratory system compensate if pH is low (acidemia)

A

An increase in the rate and depth of breathing causes more carbon dioxide to be exhaled, thereby increasing pH.

24
Q

What are the first 2 steps of figuring out an acid-base problem

A
  1. Note whether the pH is increased or decreased relative to the normal pH range.
  2. Decide which value of PCO2 or HCO3- was the primary cause of the pH change. (increased or decreased)
25
Q
  1. Respiratory acidosis and alkalosis are disorders involving changes in
  2. Metabolic acidosis and alkalosis are disorders due to changes in
A
  1. PCO2 in blood
  2. HCO3- in blood
26
Q

What are steps 3 and 4 for figuring out acid-base problems

A
  1. Specify the primary problem as respiratory or metabolic.
  2. Look at the non-causative (compensatory/secondary) value and determine if it is compensating for the primary problem.
  • Respiratory System
  • Urinary System
27
Q
  1. PCO2 > 45 mm Hg = ?
  2. PCO2 < 35 mm Hg = ?
A
  1. PCO2 > 45 mm Hg = Respiratory Acidosis (increased PCO2)
  2. PCO2 < 35 mm Hg = Respiratory Alkalosis (decreased PCO2)
28
Q
  1. HCO3- < 22mEQ/L = ?
  2. HCO3- > 26mEQ/L = ?
A
  1. HCO3- < 22mEQ/L = Metabolic Acidosis
  2. HCO3- > 26mEQ/L = Metabolic Alkalosis
29
Q

Primary causes of hypoventilation: (4)

A
  1. Anesthesia, opioids
  2. Cervical cord trauma
  3. Airway obstruction
  4. Injury to the brainstem and respiratory centers
30
Q

FYI, treatments of respiratory acidosis

A
  • Correct primary problem
  • IV administration of bicarbonate (HCO3-)
  • Ventilation therapy to increase exhalation of CO2
31
Q

in respiratory alkalosis what happens to PCO2

A

Decreased PCO2

32
Q

Primary Causes of Hyperventilation (alkalosis) (5)

A
  1. Increase in altitude
  2. Pain, distress, anxiety
  3. Hypoxemia
  4. Pulmonary disease- embolism, edema, pneumonia
  5. Iatrogenic– Mechanical Ventilation
33
Q

What does iatrogenic mean?

A
  • meaning you yourself have caused that problem
  • ex. giving to much steroids/ glucocorticoids will cause your patient to develop iatrogenic cushings
34
Q

Primary Metabolic causes of Metabolic Acidosis

A
  • Decreased HCO3-
    • Loss of ion through diarrhea or kidney dysfunction
    • Accumulation of acid (ketosis with unmanaged diabetes)
    • Kidney failing to remove H+ from protein metabolism
35
Q

In Metabolic Acidosis what is the compensitory mechanism of the body?

A

by hyperventilation

36
Q

Fyi

  • what is the treatment of metabolic acidosis
A
  1. IV administration of sodium bicarbonate
  2. Correct the primary cause
37
Q

Primary causes of Metabolic Alkalosis (5)

A
  1. Vomiting,
  2. gastric suctioning
  3. diuretics
  4. dehydration
  5. excessive intake of alkaline drugs
38
Q

In metabolic alkalosis what is the compensatory mechanism of the body?

A

hypoventilation

39
Q

FYI what is the treatment of metabolic alkalosis

A
  1. Fluid and electrolyte therapy
  2. Correct the primary cause
40
Q

pH = 7.25

PCO2= 30 mm Hg

HCO3- = 18 mEQ/L

  1. Primary Problem: Respiratory or Metabolic Acidosis or Alkalosis
  2. Compensatory: Respiratory or Metabolic Acidosis or Alkalosis
A
  1. Primary metabolic acidosis
  2. compensatory respiratory alkalosis
41
Q

pH = 7.60

PCO2= 20 mm Hg

HCO3- = 15 mEQ/L

  1. Primary Problem: Respiratory or Metabolic Acidosis or Alkalosis
  2. Compensatory: Respiratory or Metabolic Acidosis or Alkalosis
A
  1. Primary respiratory alkalosis
  2. compensatory metabolic acidosis
42
Q

pH = 7.10

PCO2= 60 mm Hg

HCO3- = 40 mEQ/L

  1. Primary Problem: Respiratory or Metabolic Acidosis or Alkalosis
  2. Compensatory: Respiratory or Metabolic Acidosis or Alkalosis
A
  1. primary respiratory acidosis
  2. Compensatory metabolic alkalosis
43
Q

pH = 7.7

PCO2= 60 mm Hg

HCO3- = 50 mEQ/L

  1. Primary Problem: Respiratory or Metabolic Acidosis or Alkalosis
  2. Compensatory: Respiratory or Metabolic Acidosis or Alkalosis
A
  1. primary metabolic alkalosis
  2. Compensatory respiratory acidosis

BMS 334 (Histology) (14 decks)

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