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PHYS 2 Acid Base
Physiology
| Question | Answer |
|---|---|
| definition of acid | any substance that donates a proton (H+) |
| definition of base | any substance that accepts a proton (H+) |
| pH | logarithmic relationship of H+ in the body |
| arterial pH | 7.45 |
| venous pH | 7.35 |
| why is venous pH lower than arterial pH | more H+ in venous blood because there's more CO2 |
| alkalosis | increase in pH |
| t/f: alkalosis is the same term as alkaline | false |
| acidosis | decrease in pH |
| t/f: acidosis can still be alkaline | true |
| affect of acidosis on hemaglobin | decrease affinity for O2, increase O2 in tissues |
| affect of alkalosis on hemaglobin | increase affinity for O2, decrease O2 in tissues-- hypoxic |
| t/f: acidosis is better than alkalosis | true |
| t/f: if the pH in the body is 7.0 or lower, death is likely to occur | true |
| t/f: a body pH of 7.2 begins the symptoms of feeling bad | true |
| t/f: protein rich= more acidic | true |
| how are hydrogen ions added | carbonic acid formation, inorganic acids (ingestion and protein digestion), organic acids (metabolic processes) |
| what does antifreeze do to the body? | cause severe acidosis and kidney damage |
| how are hydrogen ions removed | lungs and kidneys |
| what are chemical buffers? | substances that minimize change in pH by either accepting or donating a H+ |
| what is the primary buffer system? | bicarbonate |
| t/f: according to the henderson-hasselbach equation, if the pH of our body was 6.1 our system would be optimally performing | true |
| t/f: our body is optimally performing at a pH of 7.4 | false |
| bicarbonate equation | pH = 6.1 + log (HCO3-)/0.03*PCO2 |
| t/f: in the bicarbonate buffer system the closer the pH is to the pK, the more power the buffer has | true |
| what is the pK of bicarbonate buffers? | 6.1 |
| t/f: bicarbonate buffer is the best and strongest buffer | false |
| what is the most plentiful buffer? | protein |
| t/f: if protein values are too high it indicates dehydration | true |
| t/f: henderson-hasselbach determines a change in proteins | false |
| what is the pK of protein buffers? | 7.4 |
| hemoglobin as a buffer | unoxygenated blood has high affinity for H+ - pick up H+ from carbonic acid - stronger than bicarbonate buffer |
| phosphate buffer | intracellular and plasma, renal, utilizes H2PO4- and HPO42-, |
| pK of phosphate buffer | 6.8 |
| why is urine pH in carnivores acidic? | phosphate buffer system is effective |
| t/f: bicarbonate is difficult to filter and readily reabsorbed | false |
| where does bicarbonate reabsorption not occur? | thin portions of loop of henle |
| t/f: bicarbonate reabsorption is tied to H+ secretion | true |
| mechanism of bicarb reabsorption | secretion of H+ from the blood into tubular fluid → H+ combines with HCO3- to form H2CO3 → H2CO3 dissociates into CO2 and H2O → CO2 diffuses back into the cell and the reverse occurs → bicarb exchange for chloride → H+ secreted back into tubules |
| t/f: co2 is easily reabsorbed because it's lipid soluble | true |
| t/f: kidneys would rather reabsorb co2 than h2o | false |
| where is bicarb exchanged for chloride? | interstitial fluid of distal tubules |
| t/f: kidneys balance themselves | true |
| what happens if there is not enough hydrogen ions in the tubular lumen? | bicarb is lost which increases pH, bicarb excreted into urine until back to normal |
| what are the acid secreting cells of tubules? | Type A intercalated cells |
| what are the base secreting cells of tubules? | Type B intercalated cells |
| what cells are better for correcting alkalosis in the tubules? | type B |
| phosphate buffer system | - H+ in lumen in exchange for Na+ - Sodium on Na2HPO4 - New bicarb formed - NaH2PO4 |
| ammonia buffer system | - NH3 & NH4 - based on glutamate: forms 2 ammonium ions and 2 bicarbs - ammonium ions secreted - eliminates 50% of H+ - produces 50% of bicarb |
| what buffer system kicks in when there is an excess of H+ excretion | phosphate buffer system and ammonia buffer system |
| what happens to bicarb when you secrete more hydrogens? | reabsorb more bicarb |
| what does an increase in pCO2 in the ECF do to pH? | decrease |
| What does a decrease in pCO2 in the ECF do to pH? | increase |
| how do the lungs respond to adjust the rate of CO2 eliminated? | increased alveolar ventilation or decreased alveolar ventilation |
| t/f: respiratory rate doesn't decrease well meaning we don't compensate for alkalosis very well | true |
| what gasses are measured for acid-base disturbances? | oxygen and carbon dioxide |
| where are blood gasses measured? | arterial |
| respiratory acidosis | decrease pH increase H+ INCREASE pCO2 increase bicarb |
| respiratory alkalosis | increase pH decrease H+ DECREASE pCO2 decrease bicarb |
| metabolic acidosis | decrease pH increase H+ decrease pCO2 DECREASE bicarb |
| metabolic alkalosis | increase pH decrease H+ increase pCO2 INCREASE buffer |
| base excess equation | bicarb + 10(pH - 7.4) - 24 |
| what does a negative value for base excess equation indicate? | depletion of bicarb |
| t/f: base excess tells the cause | false |
| what is an anion gap? | difference between measured cations in ECF (primarily sodium) and anions (bicarb and chloride) |
| how is the anion gap increased? | increasing cations or proteins |
| why is the anion gap typically around 9-13 mEq/L? | presents of proteins (unmeasured anions) |
| t/f: an anion gap is only useful in alkalosis | false (acidosis) |
| t/f: lactate is an anion | true |
| what does lactate do to the anion space? | starts to occupy the anion space and push out chloride and bicarb |
| what does a big anion gap tell us? | there is intoixation |
| t/f: there are always fewer anions than cations | true |
| causes of acidosis | - retention of CO2 - sulfuric and phosphoric acids - ketoacids - NH4Cl - Ethylene Glycol - Rapid expansion of ECF - Renal failure - Inhibit carbonic anyhdrase |
| effects of acidosis | - neuromuscular depression - CNS depression, coma - Elevated ionize calcium - Anorexia & nausea - Kussmaul breathing - Hyperkalemia |
| what does increasing ionized calcium do? | increases threshold which decreases action potential frequency and decreases excitability |
| t/f: in acidosis the PNS is affected before the CNS | true |
| what causes nausea in acidosis | elevated ionized calcium and the GI tract shuts down |
| t/f: hyperkalemia is a result of acidosis | true |
| t/f: elevated calcium levels indicate more calcium needs to be excreted | false (deposited) |
| t/f: it is hard to become alkalotic | true |
| causes of alkalosis | - bicarb administration-- iatrogenic or voluntary - vomiting - hypokalemia - hyperventilation |
| iatrogenic | "your fault" |
| t/f: vomiting with alkalosis causes you to begin to starve and causes ketoacidosis | true |
| what does ketoacidosis typically cause? | death |
| how does alkalosis cause hypokalemia | K+ and Ca+ are tightly linked |
| what is the body's response to increased sodium | vasopressin |
| what is the body's response to decreased sodium | aldosterone |
| besides sodium what does aldosterone affect | potassium |
| effects of alkalosis | - nervous system irritability - synchronous diaphragmatic flutter (horses)-- humans are asynchronous - convulsions - low ionized calcium - cardiac arrythmias |
| what is asynchronous/synchronous diaphragmatic flutter | hiccups |
| how are diaphragmatic flutters caused | hydrogen is dumped into the stomach leaving behind bicarb so it becomes slightly alkalotic which decreases threshold so when membrane potential reaches this point an AP/hiccup is triggered |
| is CO2 retention increased or decreased in respiratory acidosis | increased |
| is pH increased or decreased by holidng your breath | decreased |
| t/f: increasing volume causes acidosis | true |
| hypercapnia | - decreased effective alveolar ventilation - damaged respiratory center - respiratory obstruction - decreased respiratory surface area |
| t/f: respiratory acidosis causes hypercapnia | true |
| compensation for respiratory acidosis | - metabolic alkalosis - reabsorb bicarb - secrete ammonia - acidification of urine - intracellular buffering in exchange for potassium |
| t/f: decreasing gas exchange in the lungs indicates respiratory acidosis | true |
| t/f: a mild impairment of gas exchange indicates acidosis | false |
| t/f: a major respiratory impairment of gas exchange indicates acidosis | true |
| what does respiratory alkalosis cause | - hypocapnia - hypoxemia - pulmonary disease - direct stimulation of medullary respiratory group - mechanical ventilation |
| what causes hypocapnia | hyperventilation and increased altitude |
| t/f: hyperventilation and increased altitude is a bad combination because hemoglobin is keep oxygen so the tissues are not receiving as much | true |
| t/f: hypoxemia with respiratory alkalosis is very common | false |
| sever pulmonary disease is indicative of what and why | acidosis because CO2 cannot be sent across |
| compensation for respiratory alkalosis | metabolic acidosis and bicarb loss |
| causes of metabolic acidosis | - bicarb deficiency - w/o anion gap-- increase chloride retention - w/ anion gap-- add acids from external source or renal failure |
| t/f: kidneys exchange bicarb for chloride | true |
| t/f: renal failure is only seen with acidosis | false |
| compensation for metabolic acidosis | - respiratory alkalosis - hypocapnea - limited perfusion |
| what is the primary driver of blood through arterioles | CO2 |
| causes of metabolic alkalosis | - bicarb excess - vomiting - hypokalemia - alkalizing agents (antacids) |
| compensation of metabolic alkalosis | respiratory acidosis |
| t/f: acute means short and chronic means long | true |
| Acidosis affect on H+ secretion/excretion, bicarb reabsorption, bicarb excretion, pH of urine, compensatory change in plasma pH | - increase H+ secretion & excretion - increase bicarb reabsorption - normal bicarb excretion - acidic pH of urine - alkalinization toward normal of plasma pH |
| Alkalosis affect on H+ secretion/excretion, bicarb reabsorption, bicarb excretion, pH of urine, compensatory change in plasma pH | - decrease H+ secretion/excretion - decrease bicarb reabsorption - increase bicarb excretion - alkaline pH of urine - acidification toward normal plasma pH |
Created by:
k.murski
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