Renal Physiology Acid-Base Flashcards
what is needed to maintain integrity of cells and enzymatic function
pH
if there is an increase in H+ the body becomes
acidotic (decrease pH)
if there is a decrease in H+ the body becomes
Alkalotic (increase pH)
what is the equation for pH
HCO3 / pCO2
what is the primary cause of Acid
CO2 from break down of carbonic acid
what helps to buffer acids
bicarb
what is the diffusion process of CO2
20x more soluble than O2, will diffuse very quickly
what is the primary trigger of central chemoreceptors
carbon dioxide (CO2)
where is Bicarbonate made
in kidneys
for every HCO3 made by the kidneys, what is eliminated in the urine
one H+
where is bicarbonate reabsobed
proximal tubule
what is normal CO2 levels
35-45 mmHg
what is normal Bicarb
22-26 mEq/L
what is the pH with hyperkalemia
Acidosis
what is the effect of acidosis on the cardiovascular system
decreased cardiac output
vasodilation - hypotension
increased ectopic rhythms from unstable cellular function
hyperkalemia
what are the effects of alkalosis on the cardiovascular system
leads to excitability
ventricular tachy-arrhythmias
SVT
hypokalemia
what are the effects of acidosis on the respiratory system
tachypnea
can drop CO2 to about 10 at the lowest point
right shift
what are the effects of alkalosis on the respiratory system
low respiratory rate
left shift
what are the effects of acidosis on the CNS
decreased neurotransmitter release
decreased menal status
lethargic
what are the effects on alkalosis on the CNS
increase action potentials
seizures
tetany
what are the effects of acidosis on medications
vasopressors - significantly low pH will make these not work as well
anesthetics
insulin
what occurs in response to alteration in pH
buffering
where does buffering occur
in ECF and ICF
what is the one intracellular buffer
hemoglobin
what is the effect of hemoglobin as a buffer
bind to H+ and CO2 - forms weak acid (buffers in pH is elevating)
what occurs to the respiratory rate with alkalosis
decreases
retains CO2 and shifting pH back toward normal
what occurs to the respiratory rate with acidosis
increase
breathing off CO2 and shifting pH back toward normal
what regulates levels of CO2
lungs
what is the fastest control of pH
lungs/breathing off CO2
what is the anion gap
distinguishes between acid gain vs bicarb loss
what is a normal anion gap
8
what is abnormal anion gap
> 10-12
what is the anion gap equation
AG = Na - (Cl + HCO3)
What is MUDPILES
metabolic acidosis with elevation anion gap
Methalol
Uremia
DKA
paraldaehyde
INH/Iron
Lactic avid
Ethylen Glycol
Salicylates
