Regulation of Acid Base Balance (Lecture and DSA) Flashcards
What are nonvolatile sources of acid? how are they excreted?
Via the kidneys.
Cysteine, Methionine = Sulfuric acid
Lysine, Arginine, Histidine = Hydrochloric acid
Organic acids = Bicarb
What are volatile sources of acid? How are they excreted?
Glucose = Bicarb Fat = Bicarb Glucose = Lactate
Via the lungs
Formula for Net Acid Excretion
(Acid excretion) - (Bicarb)
[(UNH4)(V) + (UTA)(V)] - (UHCO3)(V)
What happens to NAE during Acidosis?
Increases
What happens to NAE during Alkalosis?
Decreases
What fraction of NAE does Titratable acid make up?
1/3
What fraction of NAE does NH4 make up?
2/3
What effect does hyperkalemia have on H+ secretion?
Decrease secretion
What effect does hypokalemia have on H+ secretion?
Increase secretion
What three mechanisms are utilized by the body to compensate for acid base disturbances?
Buffer system
Adjust PCO2 of the blood
Adjust NAE
Type I Renal Tubular Acidosis
Decreased secretion of H+
Type II RTA
Increased loss of HCO3
Type IV RTA
Hypoaldosteronism
Type III RTA
Mix of Type 1 and Type 2
What diseases are associated with Type I RTA?
Autoimmune disorders
What diseases are associated with Type II RTA
Fanconis Syndrome, Myeloma, Drugs
What diseases are associated with Type IV RTA?
Diabetic neuropathy, drug use
What effect does hyperkalemia have on NH4 production?
Inhibit NH4 production
What effect does hypokalemia have on NH4 production?
Stimulate NH4 production
What glycoproteins play a role in nonionic diffusion and diffusion trapping of ammonium?
Rh glycoproteins- RhBG (basolateral) and RhCG (apical and basolateral)
