Renal Physiology Acid-Base

Question 1

what is needed to maintain integrity of cells and enzymatic function

Answer 1

pH

Question 2

if there is an increase in H+ the body becomes

Answer 2

acidotic (decrease pH)

Question 3

if there is a decrease in H+ the body becomes

Answer 3

Alkalotic (increase pH)

Question 4

what is the equation for pH

Answer 4

HCO3 / pCO2

Question 5

what is the primary cause of Acid

Answer 5

CO2 from break down of carbonic acid

Question 6

what helps to buffer acids

Answer 6

bicarb

Question 7

what is the diffusion process of CO2

Answer 7

20x more soluble than O2, will diffuse very quickly

Question 8

what is the primary trigger of central chemoreceptors

Answer 8

carbon dioxide (CO2)

Question 9

where is Bicarbonate made

Answer 9

in kidneys

Question 10

for every HCO3 made by the kidneys, what is eliminated in the urine

Answer 10

one H+

Question 11

where is bicarbonate reabsobed

Answer 11

proximal tubule

Question 12

what is normal CO2 levels

Answer 12

35-45 mmHg

Question 13

what is normal Bicarb

Answer 13

22-26 mEq/L

Question 14

what is the pH with hyperkalemia

Answer 14

Acidosis

Question 15

what is the effect of acidosis on the cardiovascular system

Answer 15

decreased cardiac output
vasodilation - hypotension
increased ectopic rhythms from unstable cellular function
hyperkalemia

Question 16

what are the effects of alkalosis on the cardiovascular system

Answer 16

leads to excitability
ventricular tachy-arrhythmias
SVT
hypokalemia

Question 17

what are the effects of acidosis on the respiratory system

Answer 17

tachypnea
can drop CO2 to about 10 at the lowest point
right shift

Question 18

what are the effects of alkalosis on the respiratory system

Answer 18

low respiratory rate
left shift

Question 19

what are the effects of acidosis on the CNS

Answer 19

decreased neurotransmitter release
decreased menal status
lethargic

Question 20

what are the effects on alkalosis on the CNS

Answer 20

increase action potentials
seizures
tetany

Question 21

what are the effects of acidosis on medications

Answer 21

vasopressors - significantly low pH will make these not work as well
anesthetics
insulin

Question 22

what occurs in response to alteration in pH

Answer 22

buffering

Question 23

where does buffering occur

Answer 23

in ECF and ICF

Question 24

what is the one intracellular buffer

Answer 24

hemoglobin

Question 25

what is the effect of hemoglobin as a buffer

Answer 25

bind to H+ and CO2 - forms weak acid (buffers in pH is elevating)

Question 26

what occurs to the respiratory rate with alkalosis

Answer 26

decreases
retains CO2 and shifting pH back toward normal

Question 27

what occurs to the respiratory rate with acidosis

Answer 27

increase
breathing off CO2 and shifting pH back toward normal

Question 28

what regulates levels of CO2

Answer 28

lungs

Question 29

what is the fastest control of pH

Answer 29

lungs/breathing off CO2

Question 30

what is the anion gap

Answer 30

distinguishes between acid gain vs bicarb loss

Question 31

what is a normal anion gap

Answer 31

8

Question 32

what is abnormal anion gap

Answer 32

> 10-12

Question 33

what is the anion gap equation

Answer 33

AG = Na - (Cl + HCO3)

Question 34

What is MUDPILES

Answer 34

metabolic acidosis with elevation anion gap
Methalol
Uremia
DKA
paraldaehyde
INH/Iron
Lactic avid
Ethylen Glycol
Salicylates