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Pathophysiology Lecture 3 Exam 1

What causes Metabolic Acidosis? Inc. H+ load, Dec. H+ excretion, Bicarbonate loss
What are examples of Increased H+ load? ketoacidosis( diabetes mellitus starvation), lactic acidosis, ingestions ( ammonium chloride, methanol, ethylene glycol, salicylates)
What are examples of Decreased H+ excretion? uremia, distal renal tubule acidosis
What are some examples of Bicarbonate loss? diarrhea, ureterosigmoidoscopy, renal failure, proximal renal tubuloeacidosis
What are some manifestations of Metabolic Acidosis? headache, lethargy, proceeding to coma, Kussmaul ( deep, rapid) respirations
What is a treatment of Metabolic Acidosis? bicarbonate
What are some causes of Metabolic Alkalosis? prolonged vomiting, gastrointestinal suctioning, excessive bicarbonate intake, hyperaldosteronism, diuretic therapy
What are some manifestations of Metabolic Alkalosis? weakness, muscle cramps, tetany, slow and shallow respirations
What is Hypochloremic Alkalosis? Na+ and HCO3- are resorbed due to ECF Cl- depletion, H+ is excreted when K+ is depleted.
What is a treatment for Hypochloremic Alkalosis? ECF is expanded with NaCl.
What is Hyperaldosteronism, hypokalemia? K+ and H+ are lost, Na+ and HCO3- are reabsorbed.
What is the treatment of Hyperaldosteronism hypokalemia? K+, causes H+ resorption
What is Respiratory Acidosis? Depressed ventilation resulting in increased Pco2 and Hypercapnia( too much CO2 )
What are common causes of Respiratory Acidosis? brainstem trauma, over-sedation, respiratory muscle paralysis, disorders of lung parenchyma ( pneumonia, emphysema, asthma, bronchitis)
What are some manifestations of Respiratory Acidosis? headache, blurred vision, tremors, convulsions, coma
What are some treatments for Respiratory Acidosis? restoration of ventilation removes excess CO2, mechanical ventilation may be required
What is Respiratory Alkalosis? alveolar hyperventilation , resulting in decreased Pco2 or hypocapnia.
What is Respiratory Alkalosis caused by? hypoxemia (congestive heart failure, high altitudes), hypermetabolic states (fever, anemia, thyrotoxicosis) , cirrhosis
What are manifestations of Respiratory Alkalosis? dizziness, confusion, tingling of extremities, convulsions, and coma. Deep, rapid respiration ( tachypnea) are primary symptoms
What are treatments of Respiratory Alkalosis? correction of hypoxemia or other causes, rebreathing from paper bag.
What is acid- base balance regulated by? the lungs, kidneys, and bone
What is normal pH range? 7.38-7.42
What is the volatile body acid? H2CO3 aka carbonic acid ( eliminated as CO2)
What are non-volatile body acids? sulfuric, phosphoric acids, eliminated by renal tubules-urine)
What do buffer pairs( weak acid and conjugate base) do? absorb excess protons or OH-. located in ICF and ECF
What are the most effective plasma buffers? H2CO3 ( carbonic acid ) and HCO3-( bicarbonate) -polyatomic anion. pK 6.1 (low but effective because there is a lot of it)
What is the most effective ICF buffer? phosphate (H2PO4/ HPO4) di and monohydrophosphate
What is the pk? pH at which buffer pair is half-dissociated. The pH at which it is most effective at providing function
How do the lungs balance acid/bases in the body? they have a rapid effect. Ventilation of CO2( which rids the body of acidity) , Pco2, plasma H2CO3. Happens min/hr
How do the kidneys balance acid/bases in the body? HCO3- reabsorption and regeneration, ammonium formation, titratable acid formation. Happens hrs/days
How do the bones balance acid/bases in the body? exchanges of Ca+,(PO4)-3, and release of HCO3-. Happens hrs/ days
How does the kidney ensures a H+ is released? formation of titratable acid and formation of ammonium. These are excreted through the urine.
What is renal buffering? distal tubule secretes H+ into urine and reclaims HCO3-
1 fluidram (to minims) 60 minims
1 fluid ounce 8 fluidrams
1 gram 15.432 grains
1 kg 2.2 pounds
1 ounce (avoirdupois) 28.35 grams
1 ounce (apothecary) 31.1 grams
1 pound 454 grams
1 pound (apothecary) 373 grams
Convert C to F C = [(9/5)(C)] + 32
Convert F to C F = (5/9)(F-32)
1 ounce (apothecary to grains) 480 grains
1 gallon 128 fluid ounces



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