Wk 2 Acid/Base Flashcards
1
Q
What is pH?
A
Power of hydrogen ions
2
Q
0 is considered on pH scale
A
most acidic
3
Q
14 is considered on pH scale
A
most alkalotic
4
Q
What does [H+] indicate?
A
hydrogen ion concentration
5
Q
When hydrogen ion concentration goes up, pH goes __
A
down
6
Q
When [H+] goes down, pH goes __.
A
up
7
Q
Examples of acidic materials
A
Soda, wine, mineral water
8
Q
What are examples of bases?
A
Soap, laundry detergent
9
Q
What is the most acidic substance in the human body?
A
hydrochloric acid
10
Q
Acids have more H+ ions, so they can __ H+ ions
A
donate
11
Q
Bases have less H+ ions so they can __ H+ ions
A
accept
12
Q
Bases can give up what?
A
hydroxide ion OH-
13
Q
__ acids dissociate completely in a solution.
A
strong
14
Q
__ acids dissociate partially in a solution
A
weak
15
Q
What does it mean when an acid completely dissociates in a solution?
A
It gives up all of its hydrogen ions
16
Q
Hydrogen is a component of what 4 things in the diet?
A
Sugars
Proteins
Starches
Fats
17
Q
List 4 functions of hydrogen in the body
A
- Helps maintain cell membranes
- Helps with enzyme activity
- Component of water and keeps the body hydrated
- Helps in energy production
18
Q
What is a neutral pH?
A
7
19
Q
A neutral pH is equal __ and __?
A
H+ and OH-
20
Q
What is the typical pH of the human body?
A
7.35-7.45
21
Q
Where is the pH measured in the body?
A
Blood serum, ABGs
22
Q
Most acidic place in the body
A
stomach
23
Q
What are 2 natural defense of the cells lining the stomach?
A
Cells secrete mucus and there is bicarbonate on the surface of the epithelial cells to keep it neutral pH
24
Q
What protects the esophagus from the hydrochloric acid of the stomach?
A
lower esophageal sphincter (LES)
25
What part of the small intestine has defense mechanisms to neutralize the stomach acid?
duodenum
26
What is the pH of skeletal muscle?
6.9-7.2
27
What is the pH of bone?
7.4
28
What is the pH of the liver?
7.2
29
What is the pH of pleural fluid?
7.6
30
What electrolyte imbalances are caused by acid-base imbalance?
POTASSIUM, sodium, chloride
31
Most enzymes function in a __ pH range
narrow (7.35-7.45)
32
Acid-base imbalances can affect __
hormones
33
What curve reflects the effect of acid base imbalances on oxygen transport and delivery?
Oxyhemoglobin dissociation curve
34
If a person is acidic, this will have what affect on hemoglobin?
Hemoglobin will more readily give up oxygen at the tissues
35
If a person is basic, this will have what affect on hemoglobin?
Hemoglobin will more readily hold on to oxygen, so the tissues will struggle to oxygenate
36
Do we prefer a patient to be more acidic or more basic?
Acidic
37
What acidic pH is incompatible with life?
< 6.8
38
What basic pH is incompatible with life?
> 7.8
39
What are two types of acid in the body?
Volatile acids
| Non-volatile acids
40
Volatile acids can be converted into __
gas
41
What type of acids can be converted into gas?
Volatile acids
42
Where are volatile acids excreted/eliminated?
Lungs
43
What is an example of a volatile acid?
Carbonic acid
44
What is the chemical symbol of carbonic acid?
H2CO3
45
What does carbonic acid break up into, so that it can be expelled by the lungs?
H20
| CO2
46
Why can non-volatile acids not be converted to a gas?
They cannot be dissolved
47
What are 5 examples of non-volatile acids?
```
Lactic acid
Phosphoric acid
Sulfuric acid
Acetoacetic acid
Beta-hydroxybutyric
```
48
What organ system eliminates non-volatile acids?
Kidneys
49
What non-volatile acid is NOT eliminated by the kidneys?
Lactic acid
50
Where is lactic acid eliminated?
It's metabolized by the liver and the kidney
51
What does phosphoric acid help with?
It works with calcium to help form our strong bones and helps to support kidney function
52
How is sulfuric acid created?
When proteins are metabolized by the body
53
Where is acetoacetic acid created?
In the liver
54
You will see an increase in beta-hydroxybutyric acid with
exercise, calorie restriction
55
Which acid is diagnostic of someone with diabetic ketoacidosis?
Beta-hydroxybutryic acid
56
What other acid can be measured for DKA, but is not the primary acid measured?
Lactic acid
57
What is something to note about lactic acid?
It can be converted if oxygen is re-established to the tissues and it will be utilized for energy production
58
The body produces more acids or bases?
Acids
59
What are three reasons that the body generates a lot of acids?
1. the foods we eat
2. metabolism of lipids and proteins
3. cellular metabolism waste product
60
Cellular metabolism creates what waste product?
CO2 - a volatile acid
61
CO2 combines with H20 to make...
carbonic acid
62
What pH imbalance is more difficult to correct?
Metabolic alkalosis
63
3 ways the body maintains acid-base balance
Buffers
Respiratory system
Renal system
64
How do buffers work?
Immediately and all the time
65
The respiratory system works __ to fix acid-base imbalances but is..
rapidly, shorter lived
66
What system kicks in last and is responsible for long-term balance of acid/base?
Renal system
67
What are acid-base buffers?
Chemicals in the body that combine with an acid or base to change the pH
68
Buffers with either accept or release a __ __
hydrogen ion
69
The actions of buffers occur almost __ but is short lived
instantly
70
What are the 3 main buffer systems?
Bicarbonate -- Carbonic acid buffer
Phosphate buffer
Protein buffer (including hemoglobin)
71
What type of buffer is bicarbonate?
carbonic acid buffer
72
Where is carbonic acid located?
extra cellular fluid
73
What is a byproduct of all the metabolism that occurs in the cells?
carbon dioxide (CO2)
74
CO2 combines with H20 to form __ __
carbonic acid
75
What breaks down carbonic acid?
carbonic anhydrase
76
Where is carbonic anhydrase located?
In many tissues, especially the lungs and kidneys
77
What happens if carbonic acid travels to the lung?
It is broken down by carbonic anhydrase into H2O and CO2 so the lungs can exhale the CO2
78
What happens if carbonic acid travels to the kidneys?
It breaks down into hydrogen and bicarbonate (HCO3-) to be excreted in the urine
79
When do we give patients sodium bicarbonate?
When they are acidotic and it isn't being regulated through their respiratory system
80
What is HCO3-?
Bicarbonate
81
What is H2CO3?
Carbonic acid (water and carbon dioxide)
82
Bicarbonate is acidic or basic?
Basic
83
Someone who has overdosed on narcotics might have...
An increase in CO2 due to respiratory depression and be acidotic
84
What role do the kidneys have in the carbonic acid equation?
They get rid of hydrogen ions and generate bicarbonate (which is a base)
85
What role do the lungs have in the carbonic acid equation?
Expel CO2 which is an acid
86
H+ + HCO3- represents the role of the...
Kidneys
87
H2O + CO2 represents the role of the...
Lungs
88
What is the main intracellular buffer?
Phosphate buffer
89
What is the chemical equation of the phosphate buffer?
H+ + HPO4-2 = H2PO4-
90
How do you get a dihydrogen phosphate ion?
Hydrogen + hydrogen phosphate
91
How do we measure the acid/base buffer phosphate?
You can't, all we know is that phosphate picks up a hydrogen ion to maintain intracellular pH
92
Nearly all proteins in the body can function as __
buffers
93
What is COOH?
Carboxyl group acids
94
What are carboxyl group acids?
Weak acids that give up H+
95
What are 2 examples of carboxyl group (COOH) acids?
Amino acid
| Acetic acid
96
Amino group acids __ H+
accept
97
Amino acids have both a __ group and a __ group
Carboxyl and an amino group
98
What is the chemical equation for amino group acids?
NH2-
99
What are the two types of amino group acids?
Amino acids
| Ammonia
100
Hemoglobin as a protein buffer can attach to __
CO2
101
How does hemoglobin serve as a protein buffer?
The more CO2 that is attached to the hemoglobin the less CO2 that is available to make carbonic acid
102
Cellular compensation is part of the __ system
buffer
103
Cells like to have a __ electrical charge
neutral
104
hydrogen ions are __ charged
positively
105
potassium ions are __ charged
positively
106
Major intracellular cation
potassium
107
If a patient is acidotic, hydrogen ions can move into the cell resulting in...
Potassium moving out of the cell because it is also positively charged leading to hyperkalemia
108
Hyperkalemia resulting from acidosis can be corrected by...
the kidneys if they are functioning properly
109
What is a problem with the kidneys excreting additional potassium resulting from acidosis?
There can be a potassium depletion because it was excreted by the kidneys during acidosis. Once acidosis is corrected there is no potassium to go back
110
Buffers make small changes that are...
not long lived
111
What is the chemical equation of carbonic acid?
H2CO3
112
What type of acids can't be excreted by the lungs?
non-volatile acids (fixed) like lactic acid
113
Body pH can be adjusted by the lungs how?
Adjusting the rate and depth of respirations
114
The faster and deeper you breath the more...
CO2 you are blowing off
115
If a patient has a high hydrogen concentration (is acidotic) then the lungs might...
Increase in rate and depth to blow off additional CO2
116
If a patient is alkalotic, what will their respiratory rate and depth look like?
Both will decrease
117
Kidneys can secrete large amounts of acid except for what type of acid?
Carbonic acid
118
What method of acid/base balance is the long term regulator?
the kidneys
119
Do kidneys eliminate bases or acids?
They eliminate both
120
Kidneys can __ and __ bicarbonate ions
conserve and create
121
What method is the most effective regulator of pH?
the kidneys
122
If a patient with COPD is a CO2 retainer, what will the kidneys do?
Eventually they will compensate by holding on to bicarbonate
123
If kidneys are failing then...
pH is failing
124
Patients with renal failure often have to take __ daily to maintain normal pH
bicarbonate
125
Buffers work almost __
instantly
126
How long do respiratory mechanisms take to work?
Several minutes to hours
127
How long do renal mechanisms take to work?
Several hours to days
128
A pH of <7.35
acidosis
129
A pH of >7.45
alkalosis
130
What is the body's response to acid/base imbalances called?
Compensations
131
Complete compensation is when...
pH brought back to normal limits
132
Partial compensation is when...
Range is still outside the norms
133
What do we measure when we get an arterial blood gas?
CO2 and bicarbonate levels
134
If the acid/base problem is metabolic, how will the body compensate?
Respiratory - hyperventilation or hypoventilation can help
135
If the acid/base problem is respiratory, how will the body compensate?
Renal mechanisms can bring about metabolic compensation
136
What receptors does the brain stimulate when there is an acid/base problem?
arterial receptors
137
What is the primary controller of H2CO3 (acid) supply?
Lungs
138
What triggers the lungs to increase or decrease the rate/depth of respirations?
In the lungs, excess CO2 combines with H2O to form carbonic acid
139
Hyperventilation __ pH
increases
140
Hypoventilation __ pH
decreases
141
What do kidneys do to bicarb?
Either excrete it or reabsorb it into the bloodstream
142
What is the primary controlled or HCO3 (base) supply?
Kidneys
143
Bicarbonate (HCO3) is a __
base
144
Carbon dioxide (CO2) is a __
acid
145
ABGs: Normal CO2 level
35-45
146
ABGs: Normal HCO3 level
22-26
