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physiology (Woods) > lecture 19 (T3): renal acid-base regulation > Flashcards

lecture 19 (T3): renal acid-base regulation Flashcards

1
Q

which buffer system is most important in buffering renal tubular fluid

A

phosphate buffer system

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2
Q

compounds that dissociate incompletely into hydrogen ions and a conjugate base are members of what compound

A

weak acids

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3
Q

bicarbonate buffer system consists of ____ and _____

A

bicarbonate salt and weak acid

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4
Q

what occurs when there is a decrease in bicarbonate ion results in a decrease in the ratio of bicarbonate ion to carbon dioxide in the extra cell fluid

A

metabolic acidosis

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5
Q

what is respiratory alkalosis due to a decrease in carbon dioxide concentration caused by hyperventilation compensated by

A

renal excretion of bicarbonate ion

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6
Q

where does primary active hydrogen secretion involving a hydrogen-transporting ATPase occur

A

late distal tubule in intercalated cells

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7
Q

where does most bicarbonate reabsorption occur

A

proximal tubule

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8
Q

where is volatile acid excreted from

A

lungs

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9
Q

where is nonvolatile acids excreted form

A

kidneys

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10
Q

what are some major systems regulated H+ concentration

A

chemical acid-base buffer systems of the body fluids
respiratory center
kidneys

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11
Q

define buffer

A

substance that can reversibly bind H+

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12
Q

what does addition of a strong acid lead to in the bicarbonate buffer system

A

formation of a weak acid

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13
Q

what does addition of a strong base to the bicarbonate buffer system lead to

A

formation of weak base

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14
Q

what excretes the increases levels of HCO30 in the bicarbonate buffer system

A

kidneys

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15
Q

what do decreased CO2 levels in the bicarbonate buffer system do to respiration rate

A

decreases it

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16
Q

what is bicarbonate concentration regulated primarily by in the bicarbonate buffer system

A

kidneys

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17
Q

what is the pCO2 controlled by in the bicarbonate buffer system

A

rate of respiration

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18
Q

what is the most important extracellular buffer system

A

bicarbonate buffer system

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19
Q

what do metabolic acid base disorders primarily result form

A

change in bicarbonate concentrations in extracellular fluid

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20
Q

what does respiratory acid base disorders primarily result from

A

change in pCO2

21
Q

why is phosphate buffer system important

A

plays major role in buffering tubular fluid and intracellular fluids

22
Q

why is the phosphate buffer system important in the kidneys (2 reasons)

A

usually becomes greatly concentrated in the tubules

lower pH of the tubular fluid brings the operating range of the buffer closer to the pk of the buffer system

23
Q

what is the primary method for removing nonvolatile acids

A

through renal excretion

24
Q

what are mechanisms for regulating extracellular H+

A

kidneys reabsorb filtered extracellular H+
kidneys can secrete hydrogen ions
kidneys produce new bicarbonate ions

25
Q

where does hydrogen ion secretion via secondary transport occur

A

almost all parts of the tubules except descending and ascending thin limbs of the loop of henle

26
Q

where does bring active hydrogen secretion begin

A

in the late distal tubules in intercalated cells and involves a hydrogen-transporting ATPase

27
Q

where does the majority of bicarbonate reabsorption occur

A

proximal tubule

28
Q

why is carbonic anhydrase necessary

A

it is necessary for the formation of carbonic acid from carbon dioxide and water

29
Q

how is incomplete titration used to correct acidosis

A

in metabolic acidosis, new bicarbonate ion is added to the extracellular fluid

30
Q

how is incomplete titration used to correct alkalosis

A

in metabolic alkalosis, bicarbonate ions are removed form the extracellular fluid by renal excretion

31
Q

how does the tubular epithelium secretion hydrogen ion

A

via primary active transport

32
Q

what is active transport resulting in hydrogen ion secretion carried out by

A

intercalated cells

33
Q

how does hydrogen ion secretion in the proximal tubule occur

A

via secondary sodium-hydrogen counter-transport

34
Q

where are the sodium-hydrogen exchanges located

A

on the apical (luminal) membranes of the renal epithelial cells

35
Q

where are sodium-potassium-ATPase exchangers found

A

basal membranes

36
Q

what is the lower limit of pH that can be achieved in normal cells

A

4.5

37
Q

how are nonvolatile acids primarily removed

A

via renal excretion

38
Q

what is the minimal urine pH

A

4.5

39
Q

how are excess hydrogen ions eliminated

A

through binding with phosphate or ammonia ions

40
Q

how do the kidneys correct alkalosis

A

failing to reabsorb all the filtered bicarbonate ions or adding hydrogen ion to the extracellular fluid

41
Q

what happens when there is a decreases in the ration of bicarbonate ion to carbon dioxide in extracellular fluid

A

decrease in bicarbonate ion: metabolic acidosis

increase in CO2: respiratory acidosis

42
Q

what is the primarily compensatory response to respiratory acidosis

A

increase in plasma bicarbonate ion due to addition of new bicarbonate by the kidney

43
Q

what is the primary compensatory response to metabolic acidosis

A

increase in ventilation rate

44
Q

what is the renal compensation to metabolic acidosis

A

adds new bicarbonate ion to extracellular fluid

45
Q

in alkalosis, how is excess bicarbonate excreted

A

in urine

46
Q

what is respiratory alkalosis caused by

A

hyperventilation

47
Q

what is the compensatory response to respiratory alkalosis

A

reduction in plasma bicarbonate ion concentration caused by renal excretion of bicarbonate ion

48
Q

what is metabolic alkalosis caused by

A

rise in the extracellular fluid bicarbonate ion concentration

49
Q

what is the compensatory response to metabolic alkalosis

A

decreased ventilation

increased renal bicarbonate ion excretion

physiology (Woods) (18 decks)

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