Renal regulation of H+ Flashcards

1
Q

What is the normal pH range of ECF

A

7.35-7.45

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2
Q

Why is body pH control so important

A

protein function is dependent on pH

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3
Q

How is pH of a solution determined

A

By the hydrogen ion concentration in the solution

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4
Q

Is ICF more or less acidic than ECF

A

ICF is more acidic as its normal pH is around 7.2

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5
Q

What are chemical buffers

A

Chemicals that bind to H+ and remove it from the solution if it’s acidic or release H+ into the solution if basic

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6
Q

What is the protein buffer system

A

Amino acids bind to H+

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7
Q

What is the Bicarbonate buffer system

A

CO2 + H20 can become H2CO3 ( carbonic acid ) which can H + HCO3 ( bicarbonate ).
And vice versa

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8
Q

List the two chemical buffer systems in the body

A

Protein buffer system and Bicarbonate buffer system

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9
Q

How do physiological systems stabilize pH via the renal system

A

using acids or bases

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10
Q

How do physiological systems stabilize pH via the respiratory system

A

using volatile acids including CO2. excess H+ will cause lungs to expel a lot of CO2 as H+ is converted to CO2

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11
Q

Compare the Renal vs Respiratory buffering methods

A

Renal : greater buffering capacity but effect takes several hours or a day
Respiratory : can only excrete volatile acids but effect happens within minutes

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12
Q

What happens if one of the buffering systems breaks down

A

The other system will compensate but it is not ideal

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13
Q

Where are the two physiological buffering systems in the body

A

The renal and respiratory system

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14
Q

Describe the normal control of pH mechanism in the renal system ( Hint: 6 steps )

A

1- HCO3 & H+ are filtered at the glomerulus
2- HCO3 in filtrate combines with H+ to make H2CO3
3- dissociates into H20 and CO2 both then diffuse into tubular cells
4- H2O and CO2 recombine into H2CO3 and then dissociate into HCO3 and H+ in the tubular cells
5- HCO3 is diffused into the blood and H+ is secreted into the filtrate
6- H+ combines with more HCO3 in the filtrate and cycle starts again

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15
Q

Where is 85% of the HCO3 filtered

A

PCT

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16
Q

Where is 10% of HCO3 filtered

17
Q

Where is 5% of HCO3 filtered

A

Collecting Ducts

18
Q

Is any of HCO3 excreted and explain why or why not

A

None of the HCO3 is excreted. The purpose of filtration is to get rid of some of the H+ but the HCO3 should be kept in the body

19
Q

What happens to H+ in the nephron

A

It is constantly being reabsorbed and then secreted again. most gets secreted again and that’s why urine is acidic

20
Q

What is the normal pH is secretion of H+ is higher than reabsorption

A

Urine pH is between 4.5 - 7.4

21
Q

Describe the renal correction of acidosis ( pH < 7.35 )

A

1- Excess H+ in filtrate
2- all available HCO3 combines with H+
3- Excess CO2 in filtrate will be reabsorbed
4- H20 and CO2 recombine to make H2CO3 that dissociates into HCO3 and H+ in the tubular cells
5- HCO3 diffuses into blood to increase pH and H+ excreted into filtrate
6- no more HCO3 so excess H+ will be excreted into urine , cycle won’t start again as normal

22
Q

How is H+ buffered in the urine

A

PH below 4.5 will stop H+ secretion and limit reabsorption of HCO3
1- NH3 will be secreted by tubular cells into the filtrate
2- H+ will combine with NH3 to make NH4+
3- NH4+ can’t be reabsorbed so H+ will be excrete in urine

23
Q

What is the physiological effect of a drop in PH

A

1- effects binding of calcium to plasma protein since H+ binding to albumin then there will be more free calcium ions
2- Calcium ions block sodium channels and reduces their opening
3- AP firing in myocytes and nerves is reduced
4- membrane potential of excitable cells will stabilize and they’ll be harder to stimulate

24
Q

What conditions can result from a drop in Ph ( Hint: 3 )

A

1- Cardiovascular depression : bradycardia followed by asystole
2- CNS depression : stupor followed by coma
3- reduced muscle contraction

25
Describe what respiratory acidosis is and what can cause it
Causes : Can happen due to ventilatory failure or severe ventilatory defects ( ex: COPD ) Effect : high levels of CO2 and may have low O2 level. Slightly lower pH. Raised plasma HCO3 by the renal system to combat respiratory acidosis.
26
List the causes of Metabolic acidosis (Hint : 6)
Cause : 1- Renal injury / disease causing less H+ secretion and HCO3 reabsorption. 2- Aspirin overdose 3- Diabetic Ketoacidosis 4- Alcoholism causing kidney inflammation 5- Diarrhoea causes loss of sodium which effects H+ secreted 6- Addison's disease causes less H+ secretions because hypoaldosteronism
27
Describe biochemical effects in blood of metabolic acidosis
1- Low pH and Low ECF bicarbonate 2- normal PaO2 levels and PaCO2 levels 3- If there is compensatory deep breathing then CO2 might decrease 4- H+ levels go up and HCO3 goes down which causes an anion gap that will lead to metabolic acidosis
28
What is Kussmaul's breathing
Deep breathing removing excess CO2
29
Explain the renal correction of alkalosis mechanism ( pH> 7.5 )
1- Reduced level of H+ in filtrate means less H2CO3 formed in tubular lumen 2- Less CO2 and H20 formed and reabsorbed 3- Reduction in HCO3 reabsorbing = reducing oh H+ secretion 4- surplus of HCO3 will be excreted 5- Body will create more H+ so plasma pH can increase
30
What is the physiological effect of uncompensated alkalosis
1- Rising PH will result in less H+ binding to albumin 2- Ca binding to albumin will increase and relieve NA channels , increasing their opening 3- AP firing in myocytes and nerves is increased so excitable cells will depolarized more easily
31
What conditions can result from uncompensated alkalosis ( hint: 3 )
1- Confusion ( brain problems ) 2- Skeletal muscle spasms ( ex: diaphragm) 3- Death if not rectified
32
What can cause Respiratory Alkalosis
1- Hyperventilation : decrease PaCO2 and HCO3 so renal system won't absorb HCO3
33
What causes Metabolic acidosis
1- Bicarbonate overdose ( antacid ) : HCO3 and PaCO2 levels increase 2- Hyperaldosteronism : increase H+ secretion 3- Vomiting : loosing gastric acids
34
If acidosis is coupled with low level of HCO3 then what does that signal and how is it compensated
Metabolic Acidosis. Compensated by Respiratory expulsion of CO2 from lungs.
35
If acidosis is coupled with increase of PCO2 levels what does that signal
Respiratory acidosis. Compensated via renal by increase of HCO3 levels
36
If there is respiratory alkalosis what will happen to concentration of CO2 in blood and how is it compensated
It will decrease and Renal will compensate by decreasing HCO3 levels
37
If there is Metabolic alkalosis what will happen to HCO3 concentration and how is it compensated
it will increase and will be compensated via respiratory by increasing CO2 levels