Renal Control of Acid-Base Balance -Wolff

Question 1

what does glucose and O2 make

what does fat and O2 make

Answer 1

both make H+ and HCO-3

Question 2

what does glucose with no O2 make

Answer 2

H+ and Lactate-

Question 3

Cysteine + O2 makes

Phosphoprotein and O2 make

Answer 3

H+ and Sulfate

H+ and Phosphate

Question 4

Change in pH by 0.3 does what to [H+]

Answer 4

[H+] opposite way by half

Question 5

buffer system of lungs

Answer 5

min - hours, makes CO2 and H2O

Question 6

buffer system in ionic shifts

Answer 6

2-4 hours

Question 7

buffer system in kidneys

Answer 7

hours- days

Question 8

buffer system in in bone

Answer 8

hours to days

Question 9

when CO2 is blown off a lot then what happens to HCO3-

Answer 9

HCO3- in also decreased and then the kidney has to work to slowly increase it

Question 10

buffer in ECF

Answer 10

pK at 6.1 when half is at H2CO3 and half at HCO-3

pK at 6.8 when half is at H2PO4- and half at HPO4-2

Question 11

buffering in the RBCs

Answer 11

the RBC takes in CO2 and H2O
H+ is taken by Hb
HCO-3 leaves as Cl- enters exchange

Question 12

acidemia what happens to K+ and H+ and ICF and ECF

Answer 12

1. ECF has low pH (acidic)
2. ICF takes in H+
3. ECF takes K+

Question 13

alkalemia what happens to K+ and H+ and ICF and ECF

Answer 13

1. ECF has high pH (basic)
2. ICF gives off H+
3. ECF lowers K+

Question 14

Henderson Hasselbalch equation

Answer 14

pH = 6.1 + log (HCO-3) / (H2CO3)
pH = 6.1 log (HCO-3) / (0.03 x PaCO2)

Question 15

normal renal absorption of HCO-3

Answer 15

99%

Question 16

ascending LOH and descending LOH, which has the highest concentration at all times

Answer 16

the ascending LOH

Question 17

when making dilute urine

Answer 17

the DCT and CD are not permeable to H2O or Urea

Question 18

when making concentrated urine

Answer 18

the H2O is permeable for reabsorption after leaving the ascending thick loop and entering the CD
the Urea is also permeable at the end of the CD since so much water has left

Question 19

what is always excreted mostly

Answer 19

Cr
Inulin
Cl-
Na+

Question 20

what is mostly reabsorbed

Answer 20

HCO-3
AAs
Glucose

Question 21

how is HCO-3 reabsorbed in the PT

Answer 21

CO2 +H2O inside the PT cells makes (carbonic anhydrase) H+ and HCO3-
H+ —-> Urine
HCO-3 —-> blood
during acidic conditions

Question 22

what causes an increase in H+ SECRETION leading to increased EXCRETION

Answer 22

low plasma HCO-3
high PaCO2
low ECF volume 
high aldosterone or angiotesin 2
Hypokalemia 
*acidic conditions*

Question 23

what causes a decrease in H+ SECRETION leading to decreased EXCRETION

Answer 23

increased HCO3- plasma
high ECF volume 
low PaCO2
low aldosterone
hyperkalemia
* basic conditions*

Question 24

the H+ secreted from the PT is buffered how

phosphate

Answer 24

1. H+ out to urine = NA+ into PT cell exchange
2. H+ binds to NaHPO4-
3. NaH2PO4

Question 25

the H+ secreted from the PT is buffered how | ammonia

Answer 25

1. H+ flows to urine 2. NH3 becomes transported out from ascending limb (thin and thick) and POOLS in between it and CD 3. NH3 diffuses into the CD 4. H+ and NH3 ----> NH4+

Question 26

a-intercalated cells role in buffering and the HCO3-

Answer 26

1. H+ secreted to urine binding to either HCO-3 left inside, NaHPO4-, or NH3 2. HCO-3 is reabsorbed to blood

Question 27

B- intercalated cells role in buffering and the HCO3-

Answer 27

1. H+ reabsorbed in to blood (Cl- follows H+) | 2. HCO-3 secreted into urine

Question 28

NET Acid Excretion is calculated how

Answer 28

NAE = [(Unh4 x V) + (Uta xV) + (Uhco3- x V)]

Question 29

2/3 of NAE

Answer 29

Ammonium (NH4+) synthesis and secretion, body can make its own that need to be excreted

Question 30

1/3 of NAE

Answer 30

Titratable acids = Phosphates, Cr that need to be excreted *reason excess Phosphate consumption can lead to kidney failure****