Acid Base Balance

Question 1

what is hypercarbia

Answer 1

• excess CO2

Question 2

CO2 transport intimately related to precise regulation of

Answer 2

• plasma, cellular, tissue pH

Question 3

acids other than those based on CO2 are termed

Answer 3

• metabolic acids

Question 4

what compounds constitute the primary buffer system that regulates pH

what controls these

Answer 4

• HCO3- (kidneys)

- CO2 (lungs)

Question 5

what is critical for regulation of pH

Answer 5

• ratio of bicarb/CO2

Question 6

how is HCO3- exported to plasma

Answer 6

• by the chloride shift

Question 7

what blood pH value defines acidosis

Answer 7

• below 7.35

Question 8

what blood pH value defines alkalosis

Answer 8

• above 7.45

Question 9

do acids and conjugate bases or conjugate acids and bases of weak acid/base neutralize each other

Answer 9

• no

Question 10

definition of an acid

Answer 10

• donates protons

Question 11

definition of a base

Answer 11

• accepts protons

Question 12

definition of strong acid/base

Answer 12

• dissociate completely in aqueous solutions

Question 13

when acid or base is added to a buffer

why?

Answer 13

• the solution resists pH changes

- added H+ or OH- can be neutralized by base or acid in buffer

Question 14

what happens to pH when CO2 elimination = CO2 production

Answer 14

• pH is constant

Question 15

If CO2 is eliminated faster than it is produced, what will happen to the blood

Answer 15

• blood will become alkalotic

Question 16

if more CO2 is produced than is eliminated, what will happen to the blood

Answer 16

• blood will become acidotic

Question 17

respiratory acids are eliminated by

Answer 17

• lung

Question 18

metabolic acids are eliminated by

Answer 18

• the kidney

Question 19

metabolic, non-volatile, fixed acids are

Answer 19

• end products of protein, amino acid, lipid, and nucleic acid metabolism.

Question 20

the effectiveness of a buffer is determined by

Answer 20

• its concentration pKa

- ambient pH

Question 21

buffering power is greater in what kind of system

Answer 21

• an open system

- why bicarb buffering with CO2 regulation by lung ventilation is so effective

Question 22

regulation of PCO2 and HCO3-

Answer 22

• regulated independently

Question 23

how does the cellular cytosol act as a buffer

Answer 23

• uses a combination of phosphate and protein buffers

Question 24

how does Hb act as a buffer

Answer 24

• it is rich in histidine

Question 25

time frame of cellular buffering importance of this

Answer 25

- transient | - gives the body time to react and compensate

Question 26

an importance part of physiologic buffering is moving _______ between plasma and cells

Answer 26

- acids and bases

Question 27

all volatile acids and bases are buffered how why

Answer 27

- intracellularly | - role of carbonic anhydrase inside cells

Question 28

respiratory acidosis due to result due to which condition

Answer 28

- insufficient excretion of CO2 by the lungs - PaCO2 rises, pH falls - hypoventilation

Question 29

respiratory alkalosis due to result due to which condition

Answer 29

- excess excretion of CO2 by the lungs - PaCO2 falls and plasma pH rises - hyperventilation

Question 30

role of secreted HPO4 and NH3 into tubule lumen (toward urine)

Answer 30

- bind H+ and lose more acid in the urine

Question 31

metabolic acidosis due to what does CO2 do result due to which condition

Answer 31

- metabolic acids that consume HCO3- - CO2 stays normal - becomes more acidic - hypoxia, exercise, diabetes, diarrhea

Question 32

metabolic alkalosis due to what does CO2 do result due to which condition

Answer 32

- loss of metabolic acids that increase plasma HCO3- - CO2 normal - becomes more alkalotic - excess emesis, diuretics

Question 33

compensation for respiratory acidosis

Answer 33

- kidney increases secretion of H+ in urine and retains HCO3- in plasma

Question 34

compensation for respiratory alkalosis

Answer 34

- kidney decreases secretion of H+ and decreases retention of HCO3-

Question 35

time of response from renal

Answer 35

- renal response takes 6-12 hours

Question 36

compensation for metabolic acidosis

Answer 36

- ventilation increases to decrease CO2 to normalize pH

Question 37

what is Kussmaul breathing

Answer 37

- rapid shallow breathing that can progress to deep labored breathing in severe diabetic kept acidosis

Question 38

compensation for metabolic alkalosis

Answer 38

- body decreases ventilation to increase CO2

Question 39

what is the normal range of anion gap

Answer 39

- 3-16

Question 40

what does anion gap and electro-neutrality mean which are more how is that compensated for

Answer 40

- equal numbers of positive and negative charges - more cations than anions - made up by negative charges on proteins and minor organic phosphates

Question 41

what will acid or base insults do?

Answer 41

- consume or generate HCO3-

Question 42

what happens to the ion gap in DKA

Answer 42

- anions acetoacetate and beta-hydroxybutyrate increase which creates high anion gap

Question 43

plasma pH is sensed by chemoreceptors where

Answer 43

- in the brain

Question 44

response of brain chemoreceptors to acidosis

Answer 44

- excites them to increase ventilation

Question 45

response of brain chemoreceptors to alkalosis

Answer 45

- quiets them to decrease ventilation

Question 46

time frame for respiratory compensation

Answer 46

- very rapid, minutes