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Pathopharmacology II > Wk 2 Acid/Base > Flashcards

Wk 2 Acid/Base Flashcards

1
Q

What is pH?

A

Power of hydrogen ions

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2
Q

0 is considered on pH scale

A

most acidic

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3
Q

14 is considered on pH scale

A

most alkalotic

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4
Q

What does [H+] indicate?

A

hydrogen ion concentration

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5
Q

When hydrogen ion concentration goes up, pH goes __

A

down

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6
Q

When [H+] goes down, pH goes __.

A

up

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7
Q

Examples of acidic materials

A

Soda, wine, mineral water

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8
Q

What are examples of bases?

A

Soap, laundry detergent

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9
Q

What is the most acidic substance in the human body?

A

hydrochloric acid

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10
Q

Acids have more H+ ions, so they can __ H+ ions

A

donate

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11
Q

Bases have less H+ ions so they can __ H+ ions

A

accept

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12
Q

Bases can give up what?

A

hydroxide ion OH-

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13
Q

__ acids dissociate completely in a solution.

A

strong

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14
Q

__ acids dissociate partially in a solution

A

weak

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15
Q

What does it mean when an acid completely dissociates in a solution?

A

It gives up all of its hydrogen ions

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16
Q

Hydrogen is a component of what 4 things in the diet?

A

Sugars
Proteins
Starches
Fats

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17
Q

List 4 functions of hydrogen in the body

A
  1. Helps maintain cell membranes
  2. Helps with enzyme activity
  3. Component of water and keeps the body hydrated
  4. Helps in energy production
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18
Q

What is a neutral pH?

A

7

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19
Q

A neutral pH is equal __ and __?

A

H+ and OH-

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20
Q

What is the typical pH of the human body?

A

7.35-7.45

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21
Q

Where is the pH measured in the body?

A

Blood serum, ABGs

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22
Q

Most acidic place in the body

A

stomach

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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

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24
Q

What protects the esophagus from the hydrochloric acid of the stomach?

A

lower esophageal sphincter (LES)

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25
Q

What part of the small intestine has defense mechanisms to neutralize the stomach acid?

A

duodenum

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26
Q

What is the pH of skeletal muscle?

A

6.9-7.2

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27
Q

What is the pH of bone?

A

7.4

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28
Q

What is the pH of the liver?

A

7.2

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29
Q

What is the pH of pleural fluid?

A

7.6

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30
Q

What electrolyte imbalances are caused by acid-base imbalance?

A

POTASSIUM, sodium, chloride

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31
Q

Most enzymes function in a __ pH range

A

narrow (7.35-7.45)

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32
Q

Acid-base imbalances can affect __

A

hormones

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33
Q

What curve reflects the effect of acid base imbalances on oxygen transport and delivery?

A

Oxyhemoglobin dissociation curve

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34
Q

If a person is acidic, this will have what affect on hemoglobin?

A

Hemoglobin will more readily give up oxygen at the tissues

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35
Q

If a person is basic, this will have what affect on hemoglobin?

A

Hemoglobin will more readily hold on to oxygen, so the tissues will struggle to oxygenate

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36
Q

Do we prefer a patient to be more acidic or more basic?

A

Acidic

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37
Q

What acidic pH is incompatible with life?

A

< 6.8

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38
Q

What basic pH is incompatible with life?

A

> 7.8

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39
Q

What are two types of acid in the body?

A

Volatile acids

Non-volatile acids

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40
Q

Volatile acids can be converted into __

A

gas

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41
Q

What type of acids can be converted into gas?

A

Volatile acids

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42
Q

Where are volatile acids excreted/eliminated?

A

Lungs

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43
Q

What is an example of a volatile acid?

A

Carbonic acid

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44
Q

What is the chemical symbol of carbonic acid?

A

H2CO3

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45
Q

What does carbonic acid break up into, so that it can be expelled by the lungs?

A

H20

CO2

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46
Q

Why can non-volatile acids not be converted to a gas?

A

They cannot be dissolved

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47
Q

What are 5 examples of non-volatile acids?

A 
Lactic acid
Phosphoric acid
Sulfuric acid
Acetoacetic acid 
Beta-hydroxybutyric
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48
Q

What organ system eliminates non-volatile acids?

A

Kidneys

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49
Q

What non-volatile acid is NOT eliminated by the kidneys?

A

Lactic acid

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50
Q

Where is lactic acid eliminated?

A

It’s metabolized by the liver and the kidney

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51
Q

What does phosphoric acid help with?

A

It works with calcium to help form our strong bones and helps to support kidney function

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52
Q

How is sulfuric acid created?

A

When proteins are metabolized by the body

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53
Q

Where is acetoacetic acid created?

A

In the liver

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54
Q

You will see an increase in beta-hydroxybutyric acid with

A

exercise, calorie restriction

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55
Q

Which acid is diagnostic of someone with diabetic ketoacidosis?

A

Beta-hydroxybutryic acid

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56
Q

What other acid can be measured for DKA, but is not the primary acid measured?

A

Lactic acid

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57
Q

What is something to note about lactic acid?

A

It can be converted if oxygen is re-established to the tissues and it will be utilized for energy production

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58
Q

The body produces more acids or bases?

A

Acids

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59
Q

What are three reasons that the body generates a lot of acids?

A
  1. the foods we eat
  2. metabolism of lipids and proteins
  3. cellular metabolism waste product
60
Q

Cellular metabolism creates what waste product?

A

CO2 - a volatile acid

61
Q

CO2 combines with H20 to make…

A

carbonic acid

62
Q

What pH imbalance is more difficult to correct?

A

Metabolic alkalosis

63
Q

3 ways the body maintains acid-base balance

A

Buffers
Respiratory system
Renal system

64
Q

How do buffers work?

A

Immediately and all the time

65
Q

The respiratory system works __ to fix acid-base imbalances but is..

A

rapidly, shorter lived

66
Q

What system kicks in last and is responsible for long-term balance of acid/base?

A

Renal system

67
Q

What are acid-base buffers?

A

Chemicals in the body that combine with an acid or base to change the pH

68
Q

Buffers with either accept or release a __ __

A

hydrogen ion

69
Q

The actions of buffers occur almost __ but is short lived

A

instantly

70
Q

What are the 3 main buffer systems?

A

Bicarbonate – Carbonic acid buffer
Phosphate buffer
Protein buffer (including hemoglobin)

71
Q

What type of buffer is bicarbonate?

A

carbonic acid buffer

72
Q

Where is carbonic acid located?

A

extra cellular fluid

73
Q

What is a byproduct of all the metabolism that occurs in the cells?

A

carbon dioxide (CO2)

74
Q

CO2 combines with H20 to form __ __

A

carbonic acid

75
Q

What breaks down carbonic acid?

A

carbonic anhydrase

76
Q

Where is carbonic anhydrase located?

A

In many tissues, especially the lungs and kidneys

77
Q

What happens if carbonic acid travels to the lung?

A

It is broken down by carbonic anhydrase into H2O and CO2 so the lungs can exhale the CO2

78
Q

What happens if carbonic acid travels to the kidneys?

A

It breaks down into hydrogen and bicarbonate (HCO3-) to be excreted in the urine

79
Q

When do we give patients sodium bicarbonate?

A

When they are acidotic and it isn’t being regulated through their respiratory system

80
Q

What is HCO3-?

A

Bicarbonate

81
Q

What is H2CO3?

A

Carbonic acid (water and carbon dioxide)

82
Q

Bicarbonate is acidic or basic?

A

Basic

83
Q

Someone who has overdosed on narcotics might have…

A

An increase in CO2 due to respiratory depression and be acidotic

84
Q

What role do the kidneys have in the carbonic acid equation?

A

They get rid of hydrogen ions and generate bicarbonate (which is a base)

85
Q

What role do the lungs have in the carbonic acid equation?

A

Expel CO2 which is an acid

86
Q

H+ + HCO3- represents the role of the…

A

Kidneys

87
Q

H2O + CO2 represents the role of the…

A

Lungs

88
Q

What is the main intracellular buffer?

A

Phosphate buffer

89
Q

What is the chemical equation of the phosphate buffer?

A

H+ + HPO4-2 = H2PO4-

90
Q

How do you get a dihydrogen phosphate ion?

A

Hydrogen + hydrogen phosphate

91
Q

How do we measure the acid/base buffer phosphate?

A

You can’t, all we know is that phosphate picks up a hydrogen ion to maintain intracellular pH

92
Q

Nearly all proteins in the body can function as __

A

buffers

93
Q

What is COOH?

A

Carboxyl group acids

94
Q

What are carboxyl group acids?

A

Weak acids that give up H+

95
Q

What are 2 examples of carboxyl group (COOH) acids?

A

Amino acid

Acetic acid

96
Q

Amino group acids __ H+

A

accept

97
Q

Amino acids have both a __ group and a __ group

A

Carboxyl and an amino group

98
Q

What is the chemical equation for amino group acids?

A

NH2-

99
Q

What are the two types of amino group acids?

A

Amino acids

Ammonia

100
Q

Hemoglobin as a protein buffer can attach to __

A

CO2

101
Q

How does hemoglobin serve as a protein buffer?

A

The more CO2 that is attached to the hemoglobin the less CO2 that is available to make carbonic acid

102
Q

Cellular compensation is part of the __ system

A

buffer

103
Q

Cells like to have a __ electrical charge

A

neutral

104
Q

hydrogen ions are __ charged

A

positively

105
Q

potassium ions are __ charged

A

positively

106
Q

Major intracellular cation

A

potassium

107
Q

If a patient is acidotic, hydrogen ions can move into the cell resulting in…

A

Potassium moving out of the cell because it is also positively charged leading to hyperkalemia

108
Q

Hyperkalemia resulting from acidosis can be corrected by…

A

the kidneys if they are functioning properly

109
Q

What is a problem with the kidneys excreting additional potassium resulting from acidosis?

A

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
Q

Buffers make small changes that are…

A

not long lived

111
Q

What is the chemical equation of carbonic acid?

A

H2CO3

112
Q

What type of acids can’t be excreted by the lungs?

A

non-volatile acids (fixed) like lactic acid

113
Q

Body pH can be adjusted by the lungs how?

A

Adjusting the rate and depth of respirations

114
Q

The faster and deeper you breath the more…

A

CO2 you are blowing off

115
Q

If a patient has a high hydrogen concentration (is acidotic) then the lungs might…

A

Increase in rate and depth to blow off additional CO2

116
Q

If a patient is alkalotic, what will their respiratory rate and depth look like?

A

Both will decrease

117
Q

Kidneys can secrete large amounts of acid except for what type of acid?

A

Carbonic acid

118
Q

What method of acid/base balance is the long term regulator?

A

the kidneys

119
Q

Do kidneys eliminate bases or acids?

A

They eliminate both

120
Q

Kidneys can __ and __ bicarbonate ions

A

conserve and create

121
Q

What method is the most effective regulator of pH?

A

the kidneys

122
Q

If a patient with COPD is a CO2 retainer, what will the kidneys do?

A

Eventually they will compensate by holding on to bicarbonate

123
Q

If kidneys are failing then…

A

pH is failing

124
Q

Patients with renal failure often have to take __ daily to maintain normal pH

A

bicarbonate

125
Q

Buffers work almost __

A

instantly

126
Q

How long do respiratory mechanisms take to work?

A

Several minutes to hours

127
Q

How long do renal mechanisms take to work?

A

Several hours to days

128
Q

A pH of <7.35

A

acidosis

129
Q

A pH of >7.45

A

alkalosis

130
Q

What is the body’s response to acid/base imbalances called?

A

Compensations

131
Q

Complete compensation is when…

A

pH brought back to normal limits

132
Q

Partial compensation is when…

A

Range is still outside the norms

133
Q

What do we measure when we get an arterial blood gas?

A

CO2 and bicarbonate levels

134
Q

If the acid/base problem is metabolic, how will the body compensate?

A

Respiratory - hyperventilation or hypoventilation can help

135
Q

If the acid/base problem is respiratory, how will the body compensate?

A

Renal mechanisms can bring about metabolic compensation

136
Q

What receptors does the brain stimulate when there is an acid/base problem?

A

arterial receptors

137
Q

What is the primary controller of H2CO3 (acid) supply?

A

Lungs

138
Q

What triggers the lungs to increase or decrease the rate/depth of respirations?

A

In the lungs, excess CO2 combines with H2O to form carbonic acid

139
Q

Hyperventilation __ pH

A

increases

140
Q

Hypoventilation __ pH

A

decreases

141
Q

What do kidneys do to bicarb?

A

Either excrete it or reabsorb it into the bloodstream

142
Q

What is the primary controlled or HCO3 (base) supply?

A

Kidneys

143
Q

Bicarbonate (HCO3) is a __

A

base

144
Q

Carbon dioxide (CO2) is a __

A

acid

145
Q

ABGs: Normal CO2 level

A

35-45

146
Q

ABGs: Normal HCO3 level

A

22-26

Pathopharmacology II (12 decks)

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