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28 Cards in this Set

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  • Back
What are the 2 groups of acids found in the body?
1. volatile acid - carbonic acid which is in equilibrium with CO2 2. fixed acids - like hydrocholirc, sulfuric, and phosphoric
Carbon dioxide is transported in the circulation in these 3 forms:
1. attached to hemoglobin 2. dissolved CO2 in the plasma 3. as bicarbonate (HCO3)
What enzyme generates carbonic acid from CO2 and water?
carbonic anhydrase, which is present in RBCs and renal tubular cells
Give 3 examples of intracellular and extracellular buffer systems used to regulate pH
1. proteins (such as albumin and gamma globulins 2. bicarbonate/CO2 buffer system 3. K+/H+ buffer system
Generally, how do the kidneys regulate pH?
- by excreting an acidic urine, the kidneys reduce the amount of acid in the extracellular fluid - by excreting an alkaline urine, the kidneys removes base from the extracellular fluid
What are the kidney's effect on H+ and HCO3 when regulating pH?
the kidney regulates pH by excreting excess H+ ions and reabsorbing or regenerating HCO3
Where does most secretion of H+ and reabsorption of HCO3 take place?
in the proximal convoluted tubule
What is the anion gap?
- the difference between the plasma concentration of the major measured cation (Na+) and the sum of the measured anions (Cl and HCO3) - this difference represents the concentration of unmeasured anions (such as phosphates, sulfates, organic acids, and proteins)
What is the normal anion gap range?
8-12 mEq/L
What conditions cause an increased anion gap?
lactic acidosis and ketoacidosis (which result from elevated levels of metabolic acids)
What conditions cause a low anion gap?
- conditions that produce a fall in unmeasured anions or a rise in unmeasured cations - examples are hyperkalemia, hypercalcemia, hypermagnesemia, lithium intoxication, or multiple myeloma
What is metabolic acidosis?
a decrease in pH due to a decrease in bicarbonate
How does the body compensate for metabolic acidosis?
- increasing the respiratory rate in an effort to decrease CO2 - in the kidney, increased H+ excretion and increased bicarbonate reabsorption
What are 4 mechanisms that can cause metabolic acidosis?
1. increased production of nonvolatile metabolic acids 2. decreased acid secretion by the kidney 3. excessive loss of bicarbonate 4. an increase in Cl-
What is the respiratory compensatory mechanism for metabolic acidosis?
- increasing ventilation to reduce PCO2 - done through deep and rapid respirations
What is the renal compensatory mechanism for metabolic acidosis?
- increase in H+ excretion - urine becomes more acidic
What is metabolic alkalosis?
an increase in pH due to increased bicarbonate levels
Name 3 sources where most of the body's plasma bicarbonate comes from
- from CO2 produced during metabolic processes - afrom reabsorption of filtered bicarbonate - generation of new bicarbonate by the kidney
What is the respiratory compensation for metabolic alkalosis?
hypoventilation to increase PCO2
What is the renal compensatory mechanism for metabolic alkalosis?
- decreased H+ excretion - decreased bicarbonate reabsorption
What are some factors that maintain alkalosis?
- decreased GFR - extracellular volume contraction - hypokalemia - hypochloremia - aldosterone excess
What is respiratory acidosis?
a decrease in pH, reflecting a decrease in ventilation, due to an increase in PCO2
What are some causes of respiratory acidosis?
- impaired ventilation as a result of decreased respiratory drive - lung disease - disorders of the chest wall and respiratory muscles - excess CO2 production
What is hypercapnia?
increased plasma PCO2
What are the compensatory mechanisms for respiratory acidosis?
- increased conservation and generation of bicarbonate - increased elimination of H+ by the kidney
What is respiratory alkalosis?
an increase in pH, resulting from an increase in alveolar ventilation, and a decrease in PCO2
What is a cause of respiratory alkalosis?
- hyperventilation
True/False: Generally, neuromuscular excitability is decreased in acidosis
In general, neuromuscular excitability is decreased in acidosis and increased in alkalosis The correct answer is: True