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