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PHRM 825 > PHRM 825: Acid-Base Balance - Acid-Base Regulation > Flashcards

PHRM 825: Acid-Base Balance - Acid-Base Regulation Flashcards

1
Q

Normal physiological pH

A

7.35-7.45

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2
Q

pH ___ is incompatable with life

A

<6.7 and >7.7

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3
Q

pH <7.35 = ______

A

acidemia

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4
Q

pH >7.45=______

A

alkalemia

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5
Q

The body regulates its pH via the _____ buffer system

A

Carbonic acid/Bicarbonate

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6
Q

Metabolic disorders involve changes in ________ levels, while respiratory disorders involve changes in _____ levels

A

H+ or HCO3- and CO2

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7
Q

The lungs compensate for ______ disorders

A

metabolic

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8
Q

The kidneys compensate for ______ disorders

A

respiratory

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9
Q

The Henderson-Hasselbach equation describes what

A

The relationship between pH and the concentrations of acid-base pairs in the buffer system

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10
Q

What is the Henderson-Hasselbach equation

A

pH = pKa + log(base/acid)

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11
Q

Carbonic anhydrase is a catalyst for what reaction?

A

H2CO3 CO2 + H2O

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12
Q

Most of the carbonic acid in plasma is in the form of _____

A

Carbon dioxide gas

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13
Q

Normal blood gas value of PaCO2

A

35-45 mmHg - Remember “40”

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14
Q

Normal blood gas value of HCO3

A

22-26 mEq/L - Remember “24”

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15
Q

Normal blood gas value of PaO2

A

95-100 mmHg

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16
Q

Normal blood gas value of SaO2

A

> 95%

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17
Q

______ is the best source for obtaining blood gas readings

A

Arterial blood

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18
Q

Acidemia ____ cardiac output (CO)

A

decreases

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19
Q

Acidemia causes ______ of cardiac contractility

A

impairment

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20
Q

Acidemia _____ pulmonary vascular resistance (PVR) and arrhythmias

A

increases

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21
Q

____ mEq/kg/day of acid consumed per day comes from oxidation of proteins and fats

A

~1

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22
Q

Aerobic metabolism of glucose produces _____ mmol of CO2 each day

A

15-20

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23
Q

Anaerobic metabolism produces ___ and ____

A

Lactic and pyruvic acid

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24
Q

Triglyceride oxidation produces ____ and _____

A

acetoacetic and beta-hydroxybutyric acid

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25
Q

Metabolism of sulfur-containing amino acids and phospholipids result in ____ and ___

A

sulfuric and phosphoric acids

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26
Q

What are 2 sulfur-containing amino acids

A

cysteine and methionine

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27
Q

____ mEq H+ from nonvolatile acids/kg of body weight must be excreted daily

A

0.8

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28
Q

Three standard mechanisms of acid regulation

A

Buffering, renal regulation, and ventilatory regulation

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29
Q

First line of defense in acid regulation

A

extracellular/intracellular buffering system

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30
Q

Buffer definition

A

Ability of a weak acid and its anion (base) to resist change in pH with addition of a strong acid or base

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31
Q

Buffers include

A

Bicarbonate/carbonic acid, phosphate, and protein

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32
Q

Principle buffer in the body

A

Bicarbonate

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33
Q

Bicarbonate has ____ onset with _____ capacity

A

Rapid; intermediate

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34
Q

HCO3- is present in largest concentrations _______

A

extracellularly

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35
Q

Bicarbonate’s supply of _____ is unlimited

A

CO2

36
Q

In the bicarbonate/carbonic acid buffering system, acidity can be controlled by ____ or ____

A

HCO3-; pCO2

37
Q

When acid is added to the carbonic acid/bicarbonate buffer system, ____ can be exhaled very rapidly

A

CO2

38
Q

Phosphates have ____ onset and _____ buffering capacity

A

intermediate; intermediate

39
Q

Extracellular inorganic phosphates have ____ buffering activity

A

limited

40
Q

Calcium phosphates in bone are ______

A

relatively inaccessible

41
Q

Albumin and hemoglobin have ___ onset and ____ buffering capacity

A

Rapid; limited

42
Q

Proteins are more effective as buffers ____ than ____

A

Intracellularly; extracellularly

43
Q

Kidneys serve 2 main purposes in acid regulation

A

Reabsorb filtered HCO3- and excrete H+ ions released from nonvolatile acids

44
Q

______ mEq of HCO3- is filtered through kidneys daily

A

4000-4500

45
Q

_____% of bicarbonate is reabsorbed by the _____ tubule

A

85-90%; proximal

46
Q

10-15% of bicarbonate is reabsorbed via the ____ tubule or _____

A

distal; collecting duct

47
Q

There is virtually no _____ in urine

A

HCO3-

48
Q

Anything limiting H+ secretion into the proximal tubule lumen results in _____

A

urinary bicarbonate losses

49
Q

H+ excretion takes place primarily in the ______

A

distal tubule

50
Q

Distal tubular hydrogen ion secretion comprises ____% of net acid excretion

A

~50%

51
Q

In the distal tube ____ combines with ___ in the presence of _____ to form ____, which breaks down to ___ and ____

A

CO2; water; carbonic anhydrase; H2CO3; H+ and HCO3-

52
Q

H+ is transported back into the tubular lumen of the kidney via ____

A

ATPase

53
Q

_____ freely crosses the distal tubular membrane and enters the _____ for absorption

A

HCO3-; peritubular capillary

54
Q

Ventilatory acid regulation has a ____ onset and ___ capacity

A

rapid; very large

55
Q

During ventilatory acid regulation ____ detect an increase in the ____ and ___ the rate and depth of ventilation

A

Chemoreceptors; PCO2 levels; increase

56
Q

Where are peripheral chemoreceptors located

A

carotid arteries and aorta

57
Q

What activates peripheral chemoreceptors

A

Arterial acidosis, hypercapnia, and hypoxia

58
Q

Hypercapnia meaning

A

High CO2

59
Q

Where are central chemoreceptors located

A

Medulla

60
Q

What activates central chemoreceptors

A

CSF acidosis

61
Q

CSF meaning

A

Cerebrospinal fluid

62
Q

Oxidation of proteins generates what

A

HCO3- and NH4+

63
Q

____ can be eliminated via urea synthesis or renal ammoniagenesis

A

NH4+

64
Q

Equation for urea synthesis

A

HCO3- + NH4+ –> Urea + CO2 + H2O

65
Q

If liver diminishes hepatic urea synthesis, _______ may occur or ____ will be coorected

A

Metabolic alkalosis; an acidotic state

66
Q

An increase or decrease in the urea cycle will affect the _____ pool

A

HCO3-

67
Q

____ compensation is very rapid

A

Respiratory

68
Q

____ compensation takes 3-5 days for max effect

A

Renal

69
Q

Adverse consequences of acidemia on the cardiovascular system

A
  • Decreased cardiac output
  • Impairment of cardiac contractility
  • Increased pulmonary vascular resistance (PVR) and arrhythmias
70
Q

Adverse consequences of acidemia on the metabolism

A
  • Insulin resistance
  • Inhibition of anaerobic glycolysis
  • Hyperkalemia
71
Q

Adverse consequences of acidemia on the CNS

A

Coma or altered mental status

72
Q

Adverse consequences of acidemia on the respiratory system

A
  • Decreased respiratory muscle strength
  • Hyperventilation –> compensation feature
  • Dyspnea
73
Q

Adverse consequences of alkalemia on the cardiovascular system

A
  • Decreased coronary blood flow
  • Arteriolar constriction
  • Decreased anginal threshold
  • Arrhythmias
  • Risk of heart attack
74
Q

Adverse consequences of alkalemia on metabolism

A

-Decreased K+, Ca, and Mg

75
Q

Adverse consequences of alkalemia on the CNS

A
  • Decreased cerebral blood flow

- Seizures

76
Q

Adverse consequences of alkalemia on the respiratory system

A

Decreased respirations

77
Q

What is the primary change of metabolic acidosis and what is it’s compensation?

A

Decreased HCO3-; Decreased PaCO2

78
Q

What is the primary change of metabolic alkalosis and what is it’s compensation?

A

Increased HCO3-; Increased PaCO2

79
Q

What is the primary change of respiratory acidosis and what is it’s compensation?

A

Increased PaCO2; Increased HCO3-

80
Q

What is the primary change of respiratory alkalosis and what is it’s compensation?

A

Decreased PaCO2; increased HCO3-

81
Q

In metabolic acidosis, what should the body do to compensate?

A

PaCO2 should fall 1 to 1.5 times the fall in plasma HCO3-

82
Q

In metabolic alkalosis, what should the body do to compensate?

A

PaCO2 should increase by 0.4 to 0.6 times the rise in plasma HCO3-

83
Q

In acute respiratory acidosis, what should the body do to compensate?

A

The plasma HCO3- should rise by 0.1 times the increase in PaCO2 plus or minus 3

84
Q

In chronic respiratory acidosis, what should the body do to compensate?

A

The plasma HCO3- should rise by 0.4 times the increase in PaCO2 plus or minus 4

85
Q

In acute respiratory alkalosis, what should the body do to compensate?

A

The plasma HCO3- should fall by 0.1 to 0.3 times the decrease in PaCo2 but usually not to less than 18 mEq/L

86
Q

In chronic respiratory alkalosis, what should the body do to compensate?

A

The plasma HCO3- should fall by 0.2 to 0.5 times the decrease in PaCO2 but usually not to less than 14 mEq/L

PHRM 825 (36 decks)

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