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Urinary > Session 6 > Flashcards

Session 6 Flashcards

1
Q

What is the normal plasma pH range?

A

7.38 7.42

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2
Q

Define Alkalaemia

A

A change in pH of the plasma above 7.42.

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3
Q

What does Alkalaemia cause?

A

Decreased free calcium in the ECF

Increased excitability of nerves –> Paraesthesia & Tetany

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4
Q

Define Acidaemia

A

A change in pH of the plasma below 7.1

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5
Q

What does Acidaemia cause?

A

Effects enzymes –> Decreased cardiac and skeletal muscle contractility, decreased Glycolysis, decreased Hepatic function, Increased K+

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6
Q

What ratio does pH depend on?

A

HCO3- to CO2

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7
Q

What determines CO2?

A

Respiration. Controlled by chemoreceptors and disturbed by respiratory disease

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8
Q

What determines HCO3-?

A

Kidney control and disturbed by metabolic diseases

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9
Q

What does Hypoventilation cause?

A

Hypercapnia
This causes a decrease in plasma pH
Respiratory Acidosis

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10
Q

What does Hyperventilation cause?

A

Hypocapnia
This causes an increase in plasma pH
Respiratory Alkalosis

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11
Q

How are respiratory acidaemia/alkalaemia compensated?

A

The kidneys will increase HCO3- (For acidaemia) and decrease HCO3- (For alkalaemia)

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12
Q

Why does Metabolic acidosis occur?

A

The tissues release more H+ into the plasma. (pH decreases). HCO3- binds this and therefore becomes depleted.

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13
Q

How does the body compensate Metabolic acidosis?

A

Peripheral chemoreceptors increase ventilation

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14
Q

Why does Metabolic alkalosis occur?

A

Plasma HCO3- is increased (Can be from vomiting)

So pH rises

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15
Q

How does the body compensate Metabolic acidosis?

A

Can only partially compensate as the ventilation needs to be decreased, but still has to fulfill the O2 needs

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16
Q

How can the kidneys correct pH problems due to respiratory issues?

A

They can create more HCO3- or vary excretion of HCO3- (Can lose HCO3- easily, but if want to increase HCO3- need to make sure they reabsorb all and make more)

17
Q

How is HCO3- made in the kidneys?

A

By the metabolic activity of the kidneys; it makes large quantities of CO2 which react with water to make HCO3- and H+ (excreted)
ALSO, make it from Amino acids, producing NH4- which is excreted

18
Q

What buffers H+ in the urine?

A

Phosphate

19
Q

What is the cellular response to acidosis?

A 
Enhanced Na+/H+ exchange
Full recovery of all HCO3-
Enhanced ammonium production in PCT
Enhanced activity of H+ ATPase in DCT
Increased capacity to transport HCO3- from tubular cells to ECF
20
Q

What can happen when HCO3- reacts with H+?

A

To maintain electroneutrality, HCO3- is replaced by another anion. This anion can vary depending on where the H+ is coming from eg lactic acid & lactate

21
Q

Define Anion gap

A

Difference in the measured cations and measured anions in serum, plasma, or urine. Normally 10-15mmol/L

22
Q

Why is the Anion gap useful?

A

It shows when HCO3- has been replaced with other anions therefore its decreased.

23
Q

What happens to the anion gap when there is an issue within the body? (that is not the Kidneys)

A

It increases

24
Q

What happens to the anion gap when there is an issue with the Kidneys?

A

It will be normal, but the blood will be acidic

25
Q

How does renal correction for acidosis work?

A

A decrease in the intracellular tubular cell pH stimulates acid secretion and HCO3- recovery so there is an increased HCO3- conc.

26
Q

How can you correct the pH after vomiting?

A

There is increased HCO3-, but the kidney can only excrete it if you correct the dehydration problem (as the kidney is trying to save solutes to keep water)

27
Q

Why can you not give HCO3- infusions to people with high HCO3-?

A

Makes sense as HCO3- would be excreted, but the body is trying to keep other electrolytes and in the process would keep HCO3- as well. Therefore it would not work.

28
Q

What is Hyperkalaemia associated with?

A

Metabolic acidosis

29
Q

What is Hypokalaemia associated with?

A

Metabolic alkalosis

30
Q

What does Hypokalaemia cause?

A

Intracellular pH of tubule cells acidic which favours H+ excretion and HCO3- recovery. Leading to metabolic alkalosis

31
Q

What does Hyperkalaemia cause?

A

Intracellular pH to become alkaline which favours HCO3- excretion therefore get metabolic acidosis

32
Q

Why is HCO3- not normally depleted?

A

The kidneys recover all HCO3-
The PCT makes HCO3- from amino acids, putting NH4- into urine
The DCT makes HCO3- and H+ from CO2. H+ is buffered in urine by phosphate and ammonia

Urinary (14 decks)

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