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28 Cards in this Set

  • Front
  • Back
extracellular buffers
NaHCO3/H2CO3
intracellular buffers
K Hb/ H Hb (hgb)
Na2 HPO4/ NaH2PO4 (phosphate)
Na protein / H+ protein
mechanism of CA
hydroxylates CO2
fast
intracellular
gives H+ & HCO3
non CA mech to get rid of CO2
hydration
slow
gives H+ & HCO3
CO2 in body
dissolved 10%
bicarb 65%
carbamin Hbg 30%
chloride shift
ionic conc increase
allows Hgb to give up O2
(water moves in)
volatile acids managed
CO2 in lung capillaries
Non-volatile acids managed
1st
-physiochem buffering
-bicarb pair (Na & OH or H & Cl)
-Cl & H+ & Na

2nd
expire excess CO2

3rd
renal comp
volume effect on HCO3
expansion- decreases absorption (oncotic)

contraction- increases
-oncotic
-RAS
mech for contraction alkalosis
b/c more osmotic pull & RAS activated
pH < 7.35
PCO2 > 45 mmHG
H2CO2 increased
respiratory acidosis
causes of respiratory acidosis
depress resp center (meds)
decrease gas exchange (pneumo)
decrease blood pumped (clot)
ICF buffering via Hgb
no K shift
kidney retain & produce HCO3
compensation for resp acidosis
pH > 7.45
PCO2 < 35 mmHg
H2CO3 decreased
respiratory alkalosis (comp)
causes of resp alkalosis
overstimulated resp ctr
-anxiety
-drugs (aspirin)
Hgb buffer & lactate
less HCO3 absorbed in kidneys
compensation for respiratory alkalosis

b/c saturation kinetics
less H+ secreted from antiport
HCO3/H2CO3 >20
acidosis

>15 may be
>25 is
pH < 7.35
HCO3 < 24 mmHg
decreased PCO2
hyperkalemia
metabolic acidemia
K/anion shift
causes of metabolic acidemia
MUDPILES
methanol, uremia, DKA, paraldehyde, inhalants (CO), lactate, ethylene glycol, salicylates

reduced excretion
excessive loss HCO3
Drug or EtOH toxicity
increased ventilation
-then-
production of HCO3 & H+ excretion
compensation for metabolic acidosis
pH > 7.45
HCO3 > 24 mmHg
increased PCO2
metabolic alkalemia (comp)
causes of metabolic alkalemia
Administered NaHCO3
loss HCL (vomit, suction)
aldosterone (Cushings)
volume contraction alkalosis (diuretics)
Normal anion gap
7-15 mM

Na - Cl - HCO3
anion gap < 6
esoteric dz
-multiple myeloma
-nephritic
-bromism
-Li
normal serum osmolality
>15 may be meta acid
>25 IS meta acid

Na x 2 + (glucose/18) + (BUN/3)
1:1 rules
anion gap
-decrease HCO3 to increase in AG

normal anion
-increase Cl to decrease HCO3
inability to excrete protons caused by...
Renal failure (decreased NH4 excretion)

Type 1 RTA (distal)
-decreased excr TA & NH4
-normal AG

Type 2 RTA (proximal)
-decreased proximal tubule HCO3
-less severe b/c b4 distal

Type 4 (aldosterone def/resist)
- stim of H-ATPase
-too much K on Na/K/2Cl get competitive inhibition
-tx by lowering K
pH <7.35
low cloride
normal anion gap
Type II RTA
-proximal tubule