Acid and Base Balance Quiz
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Questions and Answers

What are the two categories of relevant metabolic acids?

Volatile acids and nonvolatile acids.

How does the body use weak acids as chemical buffers?

Weak acids help prevent major swings in body fluid pH.

What is the only volatile acid?

Carbonic acid.

Which of the following are considered nonvolatile acids?

<p>Lactic acid (A), Sulfuric acid (B), Phosphoric acid (C), Keto acids (D), All of the above (E)</p> Signup and view all the answers

What are the three major ways the body maintains body fluid pH?

<p>Chemical buffers, lungs, and kidneys.</p> Signup and view all the answers

How do chemical buffers, including carbonic acid, help maintain body fluid pH?

<p>Chemical buffers, including carbonic acid, help maintain body fluid pH by accepting or releasing H+ ions, thus resisting changes in pH.</p> Signup and view all the answers

What is the function of the lungs in regulating blood pH?

<p>The lungs help regulate blood pH by exhaling CO2, which is a major contributor to acid production.</p> Signup and view all the answers

How do the kidneys contribute to maintaining blood pH?

<p>The kidneys regulate blood pH by excreting H+ ions and reabsorbing bicarbonate ions (HCO3-).</p> Signup and view all the answers

The protein buffer system is primarily found inside cells.

<p>True (A)</p> Signup and view all the answers

What are the three protein components that contribute to buffering action in body fluids?

<p>Amino terminals, carboxyl terminals, and radical groups.</p> Signup and view all the answers

What is the third mechanism involved in the chemical buffer system?

<p>Transcellular H+/K+ exchange system.</p> Signup and view all the answers

How does the transcellular H+/K+ exchange system function in the body?

<p>This system moves H+ and K+ ions in opposite directions between the ICF and ECF, helping regulate pH and potassium levels.</p> Signup and view all the answers

What is hyperkalemia, and how can the transcellular H+/K+ exchange system be involved?

<p>Hyperkalemia is a condition characterized by elevated potassium levels in the blood. The transcellular H+/K+ exchange system can contribute to hyperkalemia if excess H+ ions move into the ICF in exchange for K+ ions.</p> Signup and view all the answers

When does the respiratory control mechanism become active?

<p>The respiratory control mechanism is activated when the chemical buffer system is overwhelmed, typically within minutes.</p> Signup and view all the answers

What is the primary nerve that senses changes in blood pH and pCO2?

<p>The glossopharyngeal nerve.</p> Signup and view all the answers

The adjustment of bicarbonate levels through exhaling CO2 occurs more rapidly in the cerebrospinal fluid than the blood.

<p>False (B)</p> Signup and view all the answers

What is the main function of the renal control mechanisms?

<p>The renal control mechanisms provide more permanent changes in acid-base balance, although they act more slowly than the respiratory system or chemical buffers.</p> Signup and view all the answers

How do the kidneys contribute to maintaining a stable acid-base balance?

<p>The kidneys contribute by reabsorbing bicarbonate and secreting H+ ions.</p> Signup and view all the answers

What is the primary exchange system involved in the proximal convoluted tubule of the kidney?

<p>A sodium-hydrogen exchange system.</p> Signup and view all the answers

The renal control mechanisms can result in changes in acid-base balance within a few minutes.

<p>False (B)</p> Signup and view all the answers

What is the function of carbonic anhydrase in renal control?

<p>Carbonic anhydrase catalyzes the reaction between CO2 and H2O, converting them into carbonic acid and vice versa.</p> Signup and view all the answers

Why is the pH of urine regulated?

<p>The pH of urine needs to be regulated to prevent damage to the urinary passageways.</p> Signup and view all the answers

How is urine pH regulated?

<p>Urine pH is regulated by the phosphate buffer system.</p> Signup and view all the answers

What is the anion gap?

<p>The anion gap is the difference between the concentration of the body's major cation (sodium) and the sum of the major anions (bicarbonate and chloride).</p> Signup and view all the answers

How does the anion gap increase?

<p>The anion gap increases during lactic acidosis and ketoacidosis due to an accumulation of unmeasured anions, such as lactic acid and ketones, in the blood.</p> Signup and view all the answers

How does hyperchloremia affect the anion gap?

<p>Hyperchloremia, a condition where there is an excess of chloride in the blood, can maintain the anion gap within its reference range despite acidosis by buffering the extra hydrogen ions.</p> Signup and view all the answers

What is the primary cause of metabolic disorders?

<p>Metabolic disorders result from changes in plasma HCO3 concentration due to the presence of nonvolatile acids, such as lactic acid, ketone bodies, or sulfuric acid.</p> Signup and view all the answers

What is the main cause of respiratory disorders?

<p>Respiratory disorders result from changes in blood pH due to alterations in ventilation and carbon dioxide levels.</p> Signup and view all the answers

What is the difference between initiating events and compensatory events in acid-base balance?

<p>Initiating events cause an imbalance in the body's acid-base balance, while compensatory events are attempts by the body to restore balance.</p> Signup and view all the answers

Describe how metabolic acidosis can be compensated through respiratory mechanisms.

<p>Metabolic acidosis is when there is an excess of nonvolatile acids in the blood. The body compensates by increasing the rate of breathing, which expels more CO2, making the blood more alkaline.</p> Signup and view all the answers

Explain how pregnancy can trigger respiratory alkalosis and how the kidneys can compensate.

<p>Pregnancy can cause respiratory alkalosis because the growing uterus puts pressure on the diaphragm, reducing lung capacity. This hypoventilation leads to increased CO2 levels in the blood. The kidneys compensate for this by reducing their reabsorption of bicarbonate, allowing more bicarbonate to be excreted in the urine.</p> Signup and view all the answers

Which of the following factors may influence the anion gap? Select all that apply.

<p>Ketoacidosis (A), Hyperchloremia (C), Lactic acidosis (D)</p> Signup and view all the answers

What are the key differences between primary and compensatory mechanisms of pH regulation?

<p>Primary mechanisms are the initial response to an acid-base imbalance, while compensatory mechanisms are secondary responses that kick in to further restore balance.</p> Signup and view all the answers

What is the role of carbonic acid in the body's chemical buffer system?

<p>It forms bicarbonate when reacting with CO2. (D)</p> Signup and view all the answers

Which category of acids is eliminated by the lungs?

<p>Volatile acids (A)</p> Signup and view all the answers

Which of the following correctly describes how amino acids function in the buffering system?

<p>They can accept or release H+ ions. (B)</p> Signup and view all the answers

What is produced during the oxidation of sulfur-containing amino acids?

<p>Sulfuric acid (C)</p> Signup and view all the answers

How do kidneys adjust pH balance?

<p>By excreting H+ ions and absorbing bicarbonate. (D)</p> Signup and view all the answers

What is a primary function of proteins in the body’s buffering system?

<p>To accept and release H+ ions depending on pH. (B)</p> Signup and view all the answers

What distinguishes nonvolatile acids from volatile acids?

<p>Nonvolatile acids can be buffered by bicarbonate. (A)</p> Signup and view all the answers

In what way does the body primarily utilize chemical buffers?

<p>To prevent major swings in body fluid pH. (A)</p> Signup and view all the answers

What is the normal range for arterial blood HCO3- content?

<p>22-26 mmol/L (B)</p> Signup and view all the answers

How is the anion gap calculated?

<p>Na+ - (Cl- + HCO3-) (D)</p> Signup and view all the answers

What does a base deficit indicate in blood tests?

<p>Excess of fixed acids (C)</p> Signup and view all the answers

What is the typical measurement for the anion gap?

<p>8-16 mmol/L (A)</p> Signup and view all the answers

What occurs when lactic acidosis develops in terms of the anion gap?

<p>Anion gap increases (C)</p> Signup and view all the answers

What compound does CO2 convert into in the blood?

<p>Carbonic acid / HCO3- (B)</p> Signup and view all the answers

What does hyperchloremia primarily cause in the acid-base balance?

<p>Acidosis due to decreased HCO3- (B)</p> Signup and view all the answers

What do arterial blood gas tests measure to assess acid-base imbalances?

<p>Blood pH, pCO2, and HCO3- levels (A)</p> Signup and view all the answers

What happens to bicarbonate (HCO3-) when hydrogen ions (H+) are secreted in the proximal convoluted tubule?

<p>Bicarbonate is reabsorbed into the blood. (A), Bicarbonate levels in the tubular fluid decrease. (D)</p> Signup and view all the answers

What is the role of carbonic anhydrase in the reabsorption of bicarbonate?

<p>It breaks bicarbonate into carbon dioxide and hydrogen ions. (A)</p> Signup and view all the answers

How does the sodium-hydrogen exchange system in the proximal convoluted tubule operate?

<p>By donating hydrogen ions in exchange for sodium reabsorption. (C)</p> Signup and view all the answers

What condition leads to an increase in the secretion of hydrogen ions (H+) into the urine?

<p>Acidosis (B)</p> Signup and view all the answers

What effect does alkalosis have on the secretion of hydrogen ions in the distal convoluted tubule?

<p>It decreases the secretion of hydrogen ions. (C)</p> Signup and view all the answers

What happens when urines become too acidic?

<p>It can lead to damage of the urinary passageways. (D)</p> Signup and view all the answers

How does the active K+/H+ antiporter function within the distal convoluted tubule?

<p>It uses ATP to exchange potassium for hydrogen ions. (B)</p> Signup and view all the answers

What is the primary function of the phosphate buffer system in urine?

<p>To regulate urine pH and prevent acidity. (B)</p> Signup and view all the answers

What happens to potassium levels in the bloodstream during acidosis when excess H+ moves into the ICF?

<p>Potassium levels increase, potentially causing hyperkalemia. (B)</p> Signup and view all the answers

What is the primary role of renal control mechanisms in maintaining acid-base balance?

<p>They allow for more permanent changes, occurring potentially after days or weeks. (D)</p> Signup and view all the answers

How does the respiratory control mechanism respond to overwhelming chemical buffer systems?

<p>By exhaling CO2 to lower blood acidity. (A)</p> Signup and view all the answers

Which of the following correctly describes the function of the transcellular H+/K+ exchange system?

<p>It exchanges H+ ions for K+ ions between ICF and ECF. (A)</p> Signup and view all the answers

What is the impact of alkalosis on the transcellular H+/K+ exchange system?

<p>It causes H+ to move into the ECF in exchange for K+. (D)</p> Signup and view all the answers

Which nerve is responsible for sensing changes in pH and pCO2 during respiratory control?

<p>Glossopharyngeal nerve (B)</p> Signup and view all the answers

What does increased ventilation during a respiratory response primarily aim to achieve?

<p>To expel more CO2 and elevate blood pH. (A)</p> Signup and view all the answers

What is the earliest regulatory mechanism implemented in response to acidosis?

<p>Chemical buffer systems. (D)</p> Signup and view all the answers

What initiates respiratory compensation in metabolic acidosis?

<p>Increase in extracellular nonvolatile acids (B)</p> Signup and view all the answers

Which change in ventilation will cause respiratory acidosis?

<p>Decreased ventilation leading to increased pCO2 (D)</p> Signup and view all the answers

During prolonged ketosis, what is a consequence of respiratory compensation?

<p>Respiratory alkalosis due to decreased H+ (B)</p> Signup and view all the answers

How do the kidneys respond to respiratory alkalosis during pregnancy?

<p>Reabsorb less HCO3- from the urine (A)</p> Signup and view all the answers

What is the normal ratio of HCO3- to H2CO3 in acid-base balance?

<p>20:1 (C)</p> Signup and view all the answers

What triggers the initial response of the respiratory compensation mechanism?

<p>Increase in plasma acidity (A)</p> Signup and view all the answers

What is a key characteristic of compensation mechanisms in the body?

<p>Interim measures while homeostasis is reestablished (D)</p> Signup and view all the answers

Which of the following is an example of a compensatory event?

<p>Respiratory rate increase during metabolic acidosis (A)</p> Signup and view all the answers

Flashcards

Acids

Compounds that release H+ ions, lowering pH.

Bases

Compounds that accept H+ ions, raising pH.

Weak acids

Body fluids use these to maintain stable pH.

Carbonic acid

A weak acid that helps regulate pH by dissociating.

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Bicarbonate

Conjugate base of carbonic acid; important buffer.

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Volatile acids

Acid released as CO2 (carbonic acid).

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Nonvolatile acids

Produced by metabolism and regulated by kidneys.

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Sulfuric acid

Produced by metabolism of sulfur-containing amino acids.

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Phosphoric acid

Produced from oxidation of nucleic acids.

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Lactic acid

Product of anaerobic glucose breakdown.

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Keto acids

Produced by the oxidation of fatty acids and amino acids.

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Chemical buffers

First line of defense against pH changes.

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Protein buffers

Buffers within cells, mostly hemoglobin and albumin.

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Respiratory control

Regulates pH by controlling CO2 exhalation.

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Renal control

Kidneys regulate pH through bicarbonate reabsorption & H+ secretion.

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Sodium-hydrogen exchange

Kidney process that helps regulate acid-base balance.

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Anion gap

Difference between major cations & anions; indicates causes of acidosis or alkalosis.

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Metabolic disorders

Altered plasma bicarbonate levels.

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Respiratory disorders

Changes in ventilation and pCO2 affect pH.

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Compensation mechanisms

Body's temporary reactions to acidosis or alkalosis.

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Arterial blood gas test

Measures pH, pCO2, and HCO3- levels in blood.

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What's the role of weak acids in the body?

Weak acids act like chemical buffers, preventing drastic changes in body fluid pH. They can accept or release H+ ions, maintaining a stable balance.

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What are the two main categories of metabolic acids?

Metabolic acids can be classified into volatile and nonvolatile acids. Volatile acids are related to CO2, while nonvolatile acids are dealt with by the kidneys.

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How do chemical buffers maintain pH?

Chemical buffers use molecules like bicarbonate and proteins to accept or release H+ ions. This keeps pH within a narrow range.

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What are the three main pH regulation mechanisms?

The body uses chemical buffers, the lungs (CO2 exhalation), and the kidneys (H+ excretion) to maintain pH.

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How do proteins contribute to pH balance?

Proteins can act as buffers because their amino acid groups can accept or release H+ ions, helping to maintain a stable pH.

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How does the kidney contribute to acid-base balance?

The kidneys play a crucial role by excreting H+ ions and reabsorbing bicarbonate, which help maintain the proper pH.

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Transcellular H+/K+ exchange

This system uses an antiporter (a protein) to move hydrogen ions (H+) and potassium ions (K+) in opposite directions between the intracellular fluid (ICF) and the extracellular fluid (ECF).

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What happens when H+ is high in the ECF?

Excess hydrogen ions (H+) in the extracellular fluid (ECF) cause them to move into the intracellular fluid (ICF) in exchange for potassium ions (K+), potentially leading to hyperkalemia (high potassium levels in the blood).

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What happens when H+ is low in the ECF?

When hydrogen ion (H+) levels are low in the extracellular fluid (ECF), H+ moves from the intracellular fluid (ICF) to the ECF in exchange for potassium (K+), potentially causing hypokalemia (low potassium levels in the blood).

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Respiratory control mechanism

This mechanism responds rapidly to changes in blood pH by adjusting carbon dioxide (CO2) levels through breathing.

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How does respiratory control regulate pH?

The glossopharyngeal nerve senses changes in pH and CO2 levels in the blood. Increased ventilation (breathing rate) helps exhale more CO2, ultimately leading to a decrease in acidity.

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Renal control mechanism

These mechanisms, while slower than others, provide long-term pH regulation by adjusting bicarbonate levels through urine.

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How do kidneys regulate pH?

The kidneys reabsorb bicarbonate (HCO3-) and secrete hydrogen ions (H+) into the urine. This process helps maintain blood pH balance.

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Kidney's role in pH regulation

The kidney regulates pH by reabsorbing bicarbonate (HCO3-) and secreting hydrogen (H+) ions, creating a balance between the two.

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Carbonic anhydrase

This enzyme plays a crucial role in the kidney by converting carbonic acid (H2CO3) into carbon dioxide (CO2) and water (H2O), allowing for efficient reabsorption of bicarbonate.

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Potassium-hydrogen antiporter

Located in the distal convoluted tubule, this system uses energy (ATP) to exchange potassium (K+) and hydrogen (H+) ions, playing a role in regulating both pH and potassium levels.

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Urine pH regulation

The phosphate buffer system in urine prevents it from becoming too acidic by regulating its pH. If the urine is acidic, hydrogen ions are released into the cell, which leads to an increase in potassium.

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How acidosis affects potassium

Acidosis causes excess hydrogen ions to be secreted into the urine, leading to increased potassium levels in the blood.

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How alkalosis affects potassium

Alkalosis causes fewer hydrogen ions to be secreted into the urine, resulting in decreased potassium levels in the blood.

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The role of the kidneys in acid-base balance

The kidneys play a critical role in maintaining acid-base balance by regulating bicarbonate (HCO3-) levels in the blood and excreting excess hydrogen (H+) ions.

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Metabolic acidosis

A condition where the body produces too much acid or loses too much bicarbonate, leading to a decrease in blood pH.

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Respiratory acidosis

A condition where the lungs cannot eliminate CO2 efficiently, leading to an increase in blood CO2 and a decrease in blood pH.

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Metabolic alkalosis

A condition where the body loses too much acid or gains too much bicarbonate, leading to an increase in blood pH.

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Respiratory alkalosis

A condition where the lungs eliminate CO2 too quickly, leading to a decrease in blood CO2 and an increase in blood pH.

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How does ketosis lead to metabolic acidosis?

The breakdown of fats during ketosis produces ketoacids, which are acidic and increase H+ concentration in the blood, leading to metabolic acidosis.

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How does pregnancy cause respiratory alkalosis?

During pregnancy, the increased progesterone levels can stimulate faster breathing, resulting in a decrease in blood CO2 and an increase in pH, leading to respiratory alkalosis.

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What's the difference between metabolic and respiratory acid-base disorders?

Metabolic disorders are caused by alterations in bicarbonate levels, while respiratory disorders are caused by changes in ventilation and CO2 levels. Both affect blood pH.

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Why use arterial blood?

Arterial blood provides a clearer picture of the body's overall acid-base balance, as venous blood can be affected by the metabolic activities of different tissues.

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pCO2 and HCO3- levels

pCO2 measures the amount of carbon dioxide dissolved in the blood. HCO3- measures the amount of bicarbonate, a crucial buffer. These levels help indicate if acidosis or alkalosis is present.

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Base excess/deficit

Indicates how much acid or base needs to be added to blood to achieve a normal pH of 7.40. Measures all buffering systems in the blood.

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Increased anion gap

Indicates a build-up of unmeasured acids, often in conditions like ketoacidosis or lactic acidosis, caused by increased metabolic activity.

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Hyperchloremia

Increased chloride levels in the blood, potentially causing acidosis because it reduces bicarbonate in the plasma, decreasing the blood's ability to buffer.

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Anion gap and acidosis

Metabolic acidosis often causes an increased anion gap, as the body uses up bicarbonate to buffer acids like ketones, creating more unmeasured anions.

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Study Notes

Acid and Base Balance

  • Acid-base balance is crucial for maintaining proper bodily functions.
  • Acids release H⁺ ions, while bases accept H⁺ ions.
  • Body fluid pH is tightly regulated to prevent significant fluctuations.
  • Weak acids act as chemical buffers, preventing major pH swings.
  • Carbonic acid and bicarbonate form a critical buffer system, dissociating based on H⁺ ion availability.

Metabolism and Acidic Compounds

  • Metabolism produces both volatile and nonvolatile acids.
  • Volatile acids, including carbonic acid, are in equilibrium with CO₂ and eliminated by the lungs.
  • Nonvolatile acids (fixed acids) are not eliminated by the lungs and are buffered by bicarbonate and proteins.
  • Examples of common nonvolatile acids include sulfuric acid from sulfur-containing amino acids, phosphoric acid from nucleic acid metabolism, lactic acid from anaerobic glucose oxidation, and keto acids from fatty acid and amino acid oxidation.

Regulatory Mechanisms

  • The body maintains pH through three major mechanisms: chemical buffers, lungs, and kidneys.
  • Chemical buffers, like carbonic acid and proteins/amino acids, act quickly to neutralize pH changes.
  • Proteins' amino and carboxyl groups accept or release H⁺ ions.
  • Hemoglobin within red blood cells acts as a significant buffer.
  • Lungs regulate pH by controlling CO₂ levels; exhaling CO₂ reduces acidity.
  • Kidneys adjust bicarbonate levels and excrete or reabsorb H⁺ ions, providing long-term pH regulation.
  • Transcellular H⁺/K⁺ exchange mediated by an antiporter helps maintain proper concentrations within intracellular and extracellular fluids.

Respiratory Control Mechanisms

  • The glossopharyngeal nerve senses blood pH and PCO₂ changes.
  • Increased ventilation (breathing) leads to more CO₂ elimination, raising pH.
  • Bicarbonate adjustment happens more readily in the blood than cerebrospinal fluid; increased ventilation may continue even when blood pH is back to normal.

Renal Control Mechanisms

  • Renal mechanisms provide more prolonged and permanent changes in acid-base balance.

  • Reabsorption of bicarbonate (HCO₃⁻) and secretion of H⁺ ions are key renal processes in regulating pH.

  • A sodium-hydrogen exchange system, with an antiporter involved, helps regulate H⁺ concentration within proximal convoluted tubules.

  • Carbonic anhydrase breaks down H₂CO₃ into CO₂ and H₂O, facilitating CO₂ reabsorption.

Phosphate Buffer System

  • Urine needs to maintain a controlled pH to prevent tissue damage.
  • The phosphate buffer system affects urine pH.
  • H⁺ ions combine with phosphate to make monosodium phosphate. This salt is released from the body.

Laboratory Tests

  • Arterial blood gas tests (ABG) measure blood pH, PCO₂, and HCO₃⁻.
  • ABG tests determine if acidosis or alkalosis is present but not its cause.
  • Arterial blood is used since composition varies depending on metabolic activities of a tissue based on oxygen needs.
  • Determining the anion gap (difference between sodium and chloride and bicarbonate) is important for evaluating electrolyte imbalances.
  • Blood buffer base is the sum of all buffer systems in the blood.

Compensation Mechanisms

  • Metabolic disorders and respiratory disorders lead to alterations in blood pH.
  • Compensation mechanisms, involving respiratory and renal actions, help restore homeostasis.
  • For example, to compensate for metabolic acidosis, respiration increases to remove CO₂ and thus raise blood pH..
  • Kidneys eventually re-establish homeostasis by adding or removing bicarbonate (HCO3).

Review Questions

  • How do weak acid-base pairs act as buffers?
  • How is CO₂ transported in the blood?
  • Why is urine pH regulated?
  • How do proteins act as buffers?
  • How do respiration and kidneys regulate pH?
  • What is the anion gap?
  • What is the difference between primary and compensatory mechanisms in pH regulation?

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Acid and Base Balance Lecture 17 PDF

Description

Test your knowledge on acid-base balance and its importance in bodily functions. This quiz covers the role of weak acids as buffers, the difference between volatile and nonvolatile acids, and the regulatory mechanisms involved. Understand how pH levels are maintained within the body for optimal health.

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