Lecture 17 Flashcards

1
Q

What is the normal pH range of tissue fluid?

A

7.35-7.45

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2
Q

A ___ buffer is a system (for example the respiratory or urinary system) that stabilizes pH by controlling the body’s output of acids, bases, or CO2.

A

physiological

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3
Q

Any substance that binds H+ and removes it from solution as its concentration begins to rise, or releases H+ into solution as its concentration falls is classified as a ______ buffer. Examples include proteins, bicarbonate, and phosphate.

A

chemical

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4
Q

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

A

The phosphate buffer system

The protein buffer system

The bicarbonate buffer system

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5
Q

The most important buffer system in the blood is the bicarbonate buffer, which is a solution of ______ acid and bicarbonate ions.

A

weak

carbonic acid is a weak acid

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6
Q

Which would be considered a normal pH value for arterial blood?

A

7.4

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7
Q

The bicarbonate buffer system would not work very well in the human body if not for the action of the lungs and the kidneys doing which of the following?

A

Removing CO2 produced by the buffer system

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8
Q

Which two organ systems form physiological buffers that help stabilize pH by controlling the body’s output of acids, bases, or CO2? Select two options from the list below.

A

Urinary system

Respiratory system

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9
Q

The ______ buffer system is a solution of H(PO4)2 and H2(PO4).

A

phosphate

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10
Q

Which type of buffer is defined as a substance that binds H+ and removes it from solution as its concentration begins to rise, or releases H+ into solution as its concentration falls?

A

chemical

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11
Q

How can the respiratory system compensate for a drop in blood H+ concentrations?

A

Reduced pulmonary ventilation allows CO2 to accumulate, lowering the pH back to normal.

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12
Q

Name the three important chemical buffer systems in the body.

A

bicarbonate
phosphate
protein

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13
Q

Order the events during neutralization of hydrogen ions in the kidney from the moment H2CO3 forms until HCO3- returns to blood. Begin with the formation of H2CO3 in the blood at the top.

A

1) H+ in blood reacts w/ HCO3- to form H2CO3

2) H2CO3 decomposes into H2O and CO2, which enter the tubule cell

3) Tubule cells obtain CO2 from blood, and tubular fluid

4) CAH combines H2O and CO2 to re-form H2CO3

5) H2CO3 ionizes to form HCO3- (which returns to the blood) and H+

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14
Q

What is the complete chemical equation for the bicarbonate buffer system?

A

CO2 + H2O <-> H2CO3 <-> HCO3- + H+

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15
Q

If the pH of the tubular fluid drops too low, H+ concentration in the fluid is so high that tubular secretion ceases. What is the limiting pH for tubular secretion?

A

4.5

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16
Q

The bicarbonate system works quite well because the lungs and kidneys constantly remove which of the following? This prevents equilibrium from being reached.

A

CO2

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17
Q

The renal tubules are incapable of reabsorbing HCO3- directly. Instead, an enzyme breaks down the H2CO3 in the tubular fluid to form CO2, which can be reabsorbed. What is the name of the enzyme?

A

Carbonic anhydrase

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18
Q

Choose all the statements that are true regarding the phosphate buffer system.

  • it plays an important role in the renal tubules
  • it has a weaker buffering effect than an equal amount of bicarbonate buffer
  • it plays an important role in the ICF where there is constant production of metabolic acids
  • its optimal pH is 6.8
A

It plays an important role in the renal tubules.

It plays an important role in the ICF where there is constant production of metabolic acids.

Its optimal pH is 6.8.

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19
Q

Since there is so much chloride in the tubular fluid, why is H+ excreted as ammonium chloride (NH4Cl) and not simply excreted as hydrochloric acid (HCl)?

A

Because HCl is too strong of an acid and would drop the pH of the tubular fluid below the limiting pH

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20
Q

The addition of CO2 to the body fluids raises H+ concentration and lowers pH, while the removal of CO2 has the opposite effect. This is the basis for the strong buffering capacity of which system?

A

Respiratory

21
Q

Which term refers to a tissue fluid pH above 7.45?

A

Alkalosis

22
Q

Choose all the processes that occur in the kidney during the neutralization of acid.

  • Tubular cells form ammonia, which acts as a base and reacts with H+ and Cl– to form ammonium chloride (NH4Cl)
  • Tubular cells simply excrete most H+ ions as hydrochloric acid (HCl)
  • For every HCO3- that enters the peritubular capillaries, a sodium ion does too
  • The glomerular filtrate contains Na2HPO4 (dibasic sodium phosphate), which reacts with some of the H+
A

Tubular cells form ammonia, which acts as a base and reacts with H+ and Cl– to form ammonium chloride (NH4Cl)

For every HCO3- that enters the peritubular capillaries, a sodium ion does too

The glomerular filtrate contains Na2HPO4 (dibasic sodium phosphate), which reacts with some of the H+

23
Q

What must be true in order for tubular secretion of hydrogen ions to take place?

A

There is a concentration gradient between the renal tubule cell and the tubular fluid.

24
Q

Why are there are no bicarbonate ions in urine of a person with normal acid-base balance?

A

They are consumed by neutralizing H+.

25
Q

Respiratory ______ occurs when the rate of alveolar ventilation fails to keep pace with the body’s rate of CO2 production. Carbon dioxide accumulates in the ECF and lowers its pH.

A

acidosis

26
Q

Since HCl is a strong acid and would lower the pH of the tubular fluid below the limiting pH, H+ is instead excreted as which of the following?

A

Ammonium chloride

27
Q

Which results when CO2 is eliminated faster than it is produced (for example, during hyperventilation)?

A

Respiratory alkalosis

28
Q

A tissue fluid pH below 7.35 is defined as a state of Blank______.

A

acidosis

29
Q

Increased production of organic acids, such as lactic acid in anaerobic fermentation and ketone bodies in alcoholism and diabetes mellitus can cause which of the following?

A

Metabolic acidosis

30
Q

Order the events during neutralization of hydrogen ions in the kidney from the moment H2CO3 forms until HCO3- returns to blood. Begin with the formation of H2CO3 in the blood at the top.

A

(1) H+ in blood reacts w/ HCO3- to form H2CO3

(2) H2CO3 decomposes into H2O and CO2, which enter the tubule cell

(3) tubule cells obtain CO2 from blood, and tubular fluid

(4) CAH combines H2O and CO2 to re-form H2CO3

(5) H2CO3 ionizes to form HCO3- (which returns to the blood) and H+

31
Q

If the pH of the tubular fluid drops too low, H+ concentration in the fluid is so high that tubular secretion ceases. What is the limiting pH for tubular secretion?

A

4.5

32
Q

Metabolic ______ is rare, but can result from overuse of bicarbonates (such antacids and intravenous bicarbonate solutions) or from the loss of stomach acid by chronic vomiting.

A

alkalosis

33
Q

______ acidosis occurs in hypoventilation, when carbon dioxide accumulates in the ECF and lowers its pH.

A

Respiratory

34
Q

Choose all that are true regarding respiratory compensation.

  • it is equally effective in correcting all causes of acidosis and alkalosis
  • it corrects the pH of body fluids by expelling or retaining CO2
  • it is effective in correcting for PCO2 imbalances
  • it is slower than renal compensation, but better at restoring a fully normal pH
A

It corrects the pH of body fluids by expelling or retaining CO2.

It is effective in correcting for PCO2 imbalances.

35
Q

Respiratory ______ results from hyperventilation, in which CO2 is eliminated faster than it is produced.

A

alkalosis

36
Q

Describe renal compensation in response to acidosis.

A

The renal tubules increase the rate of H+ secretion.

  • renal tubules secrete H+ into the urine
37
Q

______ acidosis can result from increased production of organic acids, such as lactic acid in anaerobic fermentation and ketone bodies in alcoholism and diabetes mellitus.

A

Metabolic

38
Q

Which is likely to be increased in the urine of a person with diabetic acidosis?

A

Ammonium chloride

39
Q

Choose all the processes that occur in the kidney during the neutralization of acid.

  • tubular cells form ammonia, which acts as a base and reacts w/ H+ and Cl- to form ammonium chloride (NH4Cl)
  • the glomerular filtrate contains Na2HPO4 (dibasic sodium phosphate), which reacts w/ some of the H+
  • for every HCO3- that enters the peritubular capillaries, a sodium ion does too
  • tubular cells simply excrete most H+ ions as hydrochloric acid (HCl)
A

Tubular cells form ammonia, which acts as a base and reacts with H+ and Cl– to form ammonium chloride (NH4Cl)

The glomerular filtrate contains Na2HPO4 (dibasic sodium phosphate), which reacts with some of the H+

For every HCO3- that enters the peritubular capillaries, a sodium ion does too

40
Q

Which of the following may cause metabolic alkalosis?

A

Overuse of intravenous bicarbonate solutions or aldosterone hypersecretion

41
Q

how does aldosterone hypersecretion lead to metabolic alkalosis?

A

aldosterone causes more Na+ to be in the blood

More Na+ entering bloodstream = more HCO3- entering bloodstream = metabolic alkalosis

42
Q

Describe respiratory compensation in response to alkalosis.

A

Pulmonary ventilation rate decreases.

43
Q

Describe renal compensation in response to alkalosis.

A

The renal tubules decrease the rate of H+ secretion.

less H+ being secreted into urine = more H+ kept in bloodstream = help make basic blood more acidic

44
Q

An increase in the amount of ammonium chloride in the urine most likely indicates which of the following?

A

Acidosis

45
Q

Order the events during neutralization of hydrogen ions in the kidney from the moment H2CO3 forms until HCO3- returns to blood. Begin with the formation of H2CO3 in the blood at the top.

A

(1) H+ in blood reacts w/ HCO3- to form H2CO3

(2) H2CO3 decomposes into H2O and CO2, which enter the tubule cell

(3) tubule cells obtain CO2 from blood, and tubular fluid

(4) CAH combines H2O and CO2 to re-form H2CO3

(5) H2CO3 ionizes to form HCO3- (which returns to the blood) and H+

46
Q

Choose all that are true regarding renal compensation.

  • it adjusts for pH imbalances by changing the rate of H+ secretion by the kidneys
  • it is slower than respiratory compensation, but better at restoring a fully normal pH
  • it corrects the pH of body fluids by expelling or retaining CO2
  • it is most effective at compensating for short term pH imbalances, such as acidosis resulting from an asthma attack
A

It adjusts for pH imbalances by changing the rate of H+ secretion by the kidneys.

It is slower than respiratory compensation, but better at restoring a fully normal pH.

47
Q

Choose all the processes that occur in the kidney during the neutralization of acid.

  • tubular cells form ammonia, which acts as a base and reacts w/ H+ and Cl- to form ammonium chloride (NH4Cl)
  • The glomerular filtrate contains Na2HPO4 (dibasic sodium phosphate), which reacts with some of the H+
  • For every HCO3- that enters the peritubular capillaries, a sodium ion does too
  • Tubular cells simply excrete most H+ ions as hydrochloric acid (HCl)
A

Tubular cells form ammonia, which acts as a base and reacts with H+ and Cl– to form ammonium chloride (NH4Cl)

The glomerular filtrate contains Na2HPO4 (dibasic sodium phosphate), which reacts with some of the H+

For every HCO3- that enters the peritubular capillaries, a sodium ion does too

48
Q

Describe renal compensation in response to acidosis.

A

The renal tubules increase the rate of H+ secretion.