Renal Acid Base Regulation

Question 1

In the bicarbonate buffer system, the enzyme, , catalyzes the reaction between carbon dioxide with water to form carbonic acid.

Answer 1

Carbonic Anhydrase

Question 2

NH3 in the (section of the nephron

) binds to hydrogen ions and prevents the pH from falling.

Answer 2

Proximal Tubule

Question 3

In the kidney, most of the bicarbonate is reabsorbed in the (section of the nephron) .

Answer 3

Proximal Tubule

Question 4

The counter-transporter secretes hydrogen ions into the lumen of the proximal tubule.

Answer 4

Na H

Question 5

The system is an acid-base homeostatic mechanism involving the balance of carbonic acid, bicarbonate ion, and carbon dioxide in order to maintain pH.

Answer 5

Bicarbonate Buffer System

Question 6

In renal failure where large amounts of HCO3- is lost, it can lead to metabolic (acidosis/alkalosis) .

Answer 6

ACIDOSIS

Question 7

The two organs that plays a major role in maintaining pH in the body are .

Answer 7

LUNGS

KIDNEYS

Question 8

Decreased respiratory rate can cause retention of CO2 leading to respiratory (acidosis/alkalosis) .

Answer 8

ACIDOSIS

Question 9

A normal blood pH is between .

Answer 9

7.35-7.45

Question 10

As PCO2 increases in the blood, the pH (increases/decreases) .

Answer 10

Decreases

Question 11

As the HCO3− level increases in the blood, the pH (increases/decreases) .

Answer 11

Increases

Question 12

Increased reabsorption is a delayed compensatory response to respiratory acidosis.

Answer 12

renal HCO3

Question 13

Using the Winters formula for metabolic acidosis, if measured Pco2 is greater than predicted , there is a concomitant respiratory acidosis.

Answer 13

PCO2

Question 14

The initial disturbance of respiratory acidosis is an increased Pco2 concentration, followed by a compensatory response of (increased/decreased) HCO3-.

Answer 14

INCREASED

Question 15

An acidemia or pH less than with an increased pCO2 is classified as respiratory acidosis.

Answer 15

7.35

Question 16

Airway obstruction, chronic lung disease, opioids, sedatives, and weakening of respiratory muscles cause and therefore respiratory acidosis.

Answer 16

HYPOVENTILATION

Question 17

The initial disturbance of respiratory acidosis is an increased partial pressure of , followed by a compensatory response of increased HCO3-.

Answer 17

CO2

Question 18

(Hyperventilation/Hypoventilation) is an immediate compensatory response to metabolic acidosis.

Answer 18

HYPERVENTILATION

Question 19

Metabolic acidosis is one of the consequences of renal .

Answer 19

FAILURE

Question 20

Consequences of RENAL FAILURE

Answer 20

MAD HUNGER

Metabolic Acidosis
Dyslipidemia
HyperKALEMIA
Uremia - clinical syndrome marked by increased BUN
-nausea and anorexia
-pericarditis
-asterixis
-encephalopathy
-platelet dysfunction

Na and H20 retention (HF, PE, HPN)
Growth retardation
EPO failure (ANEMIA)
Renal osteodystrophy

Question 21

and beta-hydroxybutyric acid are metabolites of fat metabolism that can cause metabolic acidosis when they accumulate.

Answer 21

Acetoacetic Acid

Question 22

The initial disturbance of metabolic acidosis is a decreased HCO3- concentration, followed by a compensatory response of decreased .

Answer 22

PCO2

Question 23

Predicted respiratory compensation for a simple metabolic acidosis can be calculated using the .

Answer 23

Winters formula

Question 24

A metabolic acidosis is defined by an acidemia (pH less than 7.35) with a HCO3- less than mEq/L.

Answer 24

20 mEq/L

Question 25

The Winters formula used to predict the respiratory compensation for metabolic acidosis is .

Answer 25

PCO2 = 1.5 (HCO3) + 8 + 2

Question 26

The initial disturbance of metabolic acidosis is a decreased concentration, followed by a compensatory response of decreased Pco2 which helps to raise the pH back toward the normal range.

Answer 26

HCO3

Question 27

Respiratory alkalosis is a consequence of the response to (high/low) altitude.

Answer 27

HIGH

Question 28

The initial disturbance of respiratory alkalosis is a decreased concentration.

Answer 28

pCO2

Question 29

The response to high altitude has an increased renal excretion of to compensate for respiratory alkalosis.

Answer 29

HCO3

Question 30

Pulmonary emboli produce respiratory alkalosis once the body compensates for the .

Answer 30

Decrease in pulmonary blood flow

Question 31

Toxic doses of cause respiratory alkalosis early, but transitions to mixed metabolic acidosis-respiratory alkalosis.

Answer 31

ASPIRIN

Question 32

Respiratory alkalosis is an alkalemia with a pH greater than and a decreased Pco2 .

Answer 32

7.45

Question 33

Decreased renal reabsorption is a delayed compensatory response to respiratory alkalosis.

Answer 33

HCO3

Question 34

Hypertension, hypokalemia, and (acid-base disorder) are findings in Conn syndrome.

Answer 34

Metabolic Alkalosis

CONN SYNDROME

• hypokalemia
• HPN
• metabolic alkalosis

Question 35

The initial disturbance of metabolic alkalosis is an increased concentration, followed by a compensatory response of increased Pco2.

Answer 35

HCO3

Question 36

Renal medication) , thiazide diuretics, vomiting, antacid use, and hyperaldosteronism are all causes of metabolic alkalosis.

Answer 36

Loop diuretics

Question 37

Alkalosis is when the pH is greater than .

Answer 37

7.45

Question 38

is a diuretic used to alkalinize the urine or treat metabolic alkalosis as it inhibits carbonic anhydrase.

Answer 38

Carbonic Anhydrase (Acetazolamide)

Question 39

(Hyperventilation/Hypoventilation) is an immediate compensatory response to metabolic alkalosis.

Answer 39

Hypoventilation

Question 40

Hyperaldosteronism causes (acid-base disorder)

Answer 40

Metabolic Alkalosis

Question 41

Excessive vomiting results in (acid-base disorder) , secondary to vomiting of gastric acid and subsequent volume contraction

Answer 41

Metabolic alkalosis

Question 42

Bulimia nervosa is associated with (acid-base disorder) .

Answer 42

Metabolic Alkalosis

Question 43

All renal tubular defects result in metabolic alkalosis, except for .

Answer 43

Fanconi Syndrome