Module 2, Part 2 of 3

Question 1

What do Buffer Systems do:

Answer 1

-hold/release H+
-work to maintain a pH

Question 2

What Happens to blood pH if you increase Respiration Rate (Hyperventilation):

Answer 2

-breathing lots of CO2 out
-pH would increase
-equation shifts left: CO2 + H2O (both arrows) H2CO3 (both arrows) H+ + HCO3
-as more O2 is lost, more H+ will combine with HCO3 to produce CO2, therefore pH increases

Drive reaction to the left. As more CO2 is lost, more H+
will combine with HCO3- to produce CO2. Therefore pH
will increase (become more basic)

Question 3

What Happens to Blood pH if you Hypoventilate:

Answer 3

-pH goes down
-reaction driven to right

Question 4

Proximal Convoluted Tubule in Kidney:

Answer 4

-HCO3(bicarb) can return to blood via a transport
-H+ can leave the apical membrane via the NA+?H+ antiporter

Question 5

Distal Tubules:

Answer 5

-H+ can leave the urine via an H+ATPase proton pump
-combines with ammonia (NH#) to make NH4 or with HPO3 to make H2PO4 in urine
-still more hCO3 can be reabsorbed with another transporter

Question 6

Respiratory Acidosis:

Answer 6

-high level of CO2
-blood pH less than 7.35

Question 7

Respiratory Acidosis Tests:

Answer 7

-test blood pH
-CO2 levels
-bicarb test (HCO3)
-would initially see an increase in bicarb

Question 8

Respiratory Acidosis Causes:

Answer 8

-trouble breathing
-trauma to respiratory system
-bad asthma
-pulmonary edema

Question 9

Most Important Measured Blood Values in Metabolic Acidosis:

Answer 9

-low pH (acidosis), low bicarbonate (bicarbonate consumed to consume high levels of H+), and low CO2

Question 10

Case Study: patient complains of shortness of breath, blood test shows:
-pH 7.47 (range = 7.35-7.45) - should always know blood pH but other normal values will be given on test
-PCO2 30mmHg (range = 40-45mmHg)
HCO3 18mmol/L (range = 22-30 mmol/L)

Answer 10

-this client has typical pregnancy induced respiratory alkalosis:
-slightly elevated blood pH
-hyperventilating will bring CO2 levels down
-this happens in pregnant people because progesterone levels are up, that make body more sensitive to CO2 which trigger you to breathe faster and exhale CO2/keep it low
-fetus can only get rid of CO2 through mother, so if mother has high CO2 baby can’t diffuse CO2 to mother
-fetus with high CO2 would have acidosis
-this is normal/no treatment usually needed but might want to send for floor up blood test to make sure there isn’t another problem and monitor

Question 11

Case Study:
-19 year old pregnant insulin dependant
-hosty of polyuria and thirst
-afebrile (no fever)
-chest was clear, circulation was adequate
-high ketones found in urine
-high glucose levels
-low ppH
-low pCO2
-low HCO3

Answer 11

-Dx. metabolic acidosis (low pH, low CO2 and HCO3)
-Dx. diabetic ketosis due to poor compliance with diabetic treatment (supported by history and hyperglycemia)
-patient recovered but fetus died