The role of ventilation in acid/base balance Flashcards

1
Q

What does the function of proteins depend on and how is this achieved?

A

→ Depends on a specific secondary, tertiary and quaternary structure
→ Achieved by intra and inter chain bonding

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2
Q

What can denature proteins?

A

→ Temperature, pH, pressure can denature proteins

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3
Q

How is arterial pH tightly regulated?

A

→ Presence of buffering systems and regulating the level of molecules associated with acid/base production

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4
Q

What is a buffer?

A

→ Weak acid + conjugate base

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5
Q

How do buffers work when H+ is added?

A

→ When there are excess H+ ions present they are mopped up by reacting with the conjugate base to form the weak acid
→ H+ + HCO3- ⇌ H2CO3
→ The end product is much less acidic

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6
Q

How do buffers work when H+ is removed?

A

→ If H+ ions are removed the weak acid will dissociate to increase the H+ ion concentration

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7
Q

Why does the pH remain relatively stable with a buffer?

A

→ Any H+ formed by the addition of strong acid will react with the conjugate base to form a weaker acid

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8
Q

What are buffers used for?

A

→ Resisting sharp changes in pH

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9
Q

What are 3 examples of intracellular buffers?

A

→ Phosphate buffer system
→ Amino acids/ proteins
→ Haemoglobin (RBC)

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10
Q

What are 2 examples of extracellular buffers?

A

→Bicarbonate buffer system

→ Plasma proteins

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11
Q

What maintains blood homeostasis?

A

→ CO2 bicarbonate buffering system

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12
Q

How does the level of CO2 in the body determine acidity?

A

→ CO2 + H20 ⇌ H+ + HCO3-
→ CO2 reacts with water to form bicarbonate
→ Bicarbonate dissociates to form H+ and HCO3-

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13
Q

What happens during acidosis?

A

→ CO2 builds up in the blood
→ More carbonic acid is produced
→ H+ increases

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14
Q

What happens during alkalosis?

A

→ CO2 is removed from the blood
→ Less carbonic acid
→ H+ decreases

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15
Q

How do the lungs contribute to acid/base balance?

A

→ Regulate CO2 levels

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16
Q

How can you diagnose respiratory distress?

A

→ ABG and pH

17
Q

What is blood pH proportional to?

A

→ pH ∝ log (HCO3-)/PaCO2

18
Q

What does the renal system control and what is the timeframe for this?

A

→ The concentration of bicarbonate ions

→ time frame (hours to days)

19
Q

What does the respiratory system control and what is the time frame for this?

A

→ The partial pressure of CO2

→ time frame ( minutes)

20
Q

What happens if PaCO2 increases?

A

→ pH decreases

21
Q

What happens if PaCO2 decreases?

A

→ pH increases

22
Q

What happens if HCO3- increases?

A

→ pH increases

23
Q

What happens if HCO3- decreases?

A

→ pH decreases

24
Q

What is the balance of CO2 and HCO3- like in acidosis?

A

→ CO2 is too high

→ HCO3- is too low

25
Q

What is respiratory acidosis?

A

→ CO2 is too high

26
Q

What is metabolic acidosis?

A

→ HCO3- is too low

27
Q

What is the balance of CO2 and HCO3- like in alkalosis?

A

→ CO2 is too low

→ HCO3- is too high

28
Q

What is respiratory alkalosis?

A

→ CO2 is low

29
Q

What is metabolic alkalosis?

A

→ HCO3- is too high

30
Q

What are the causes of acidosis?

A
→ Hypercapnia
→ Increased lactic acid
→ Increased ketone bodies
→ Decreased kidney acid excretion
→ Decreased HCO3- reabsorption
→ Diarrhoea
31
Q

What are the effects of acidosis?

A
→ Tachypnoea
→ Muscular weakness
→ Headache
→ Confusion + coma
→ Cardiac arrhythmia
→ Hyperkalaemia
32
Q

What are the compensatory mechanisms for acidosis?

A

→ Hyperventilation

→ Decrease in HCO3- excretion

33
Q

What are the causes of alkalosis?

A

→ Hypocapnia
→ Vomiting
→ Increased kidney acid excretion
→ Increased alkalotic agent consumption

34
Q

What are the effects of alkalosis?

A
→ Bradypnoea
→ Muscular weakness, cramps, tetany
→ Headache, nausea
→ Lightheadedness, confusion + coma
→ Cardiac arrhythmia 
→ Hypokalaemia
35
Q

What are compensatory mechanisms for alkalosis?

A

→ Hypoventilation

→ Increased HCO3- excretion

36
Q

How can acidosis induce hyperkalaemia?

A

Acidosis increases the concentration of extracellular H+

Decreases the concentration gradient

Less H+ excretion via the H+/ Na+ exchange

Decreased levels of Na+ affect the Na+/K+ exchange

Decreasing the K+ absorption into the cell

K+ accumulation in the serum is hyperkalaemia

Leads to cardiac arrhythmias and muscle weakness

37
Q

How can alkalosis induce cerebral vasoconstriction?

A

CO2 acts as a vasodilator in blood vessels

In alkalosis with decreased CO2 and H+ there is vasoconstriction in cerebral arteries

Decrease leads to headaches, lightheadedness, confusion + seizures