Acid-Base Balance and Regulation
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Acid-Base Balance and Regulation

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Questions and Answers

What is the primary source of H+ ions in the body?

  • Metabolic reaction involving sulfuric acid
  • Cellular ion exchange
  • Reaction involving CO2 and H2O (correct)
  • Protein buffering system

    • What is the function of the buffering system in the body?

  • To regulate the concentration of K+ ions
  • To eliminate volatile acids from the body
  • To maintain a constant pH by binding excessive H+ or OH- ions (correct)
  • To regulate the concentration of HCO3- ions

    • What is the fate of nonvolatile metabolic acids in the body?

  • They are neutralized by hydroxide ions
  • They are eliminated through the kidneys through regulation of bicarb (correct)
  • They are buffered by the hemoglobin in plasma
  • They are eliminated through the lungs

    • What is the significance of the pH range of 6.8-7.8?

    <p>Death occurs outside of this range</p> Signup and view all the answers

    What happens to K+ ions in acidosis?

    <p>They increase</p> Signup and view all the answers

    What is the role of the lungs in acid-base balance?

    <p>They eliminate volatile acids, such as carbonic acid, as CO2</p> Signup and view all the answers

    What is the primary mechanism by which the kidneys compensate for respiratory acidosis?

    <p>Reabsorption of bicarbonate</p> Signup and view all the answers

    What is the ratio of bicarbonate to carbonic acid at a pH of 7.4?

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

    What is the effect of metabolic alkalosis on the body?

    <p>Both A and B</p> Signup and view all the answers

    What is the effect of hyperventilation on the body?

    <p>Respiratory alkalosis</p> Signup and view all the answers

    What is the primary mechanism by which the lungs compensate for metabolic acidosis?

    <p>Increased ventilation</p> Signup and view all the answers

    What is the normal range for pH in the human body?

    <p>7.35-7.45</p> Signup and view all the answers

    What happens to the concentration of H+ ions in the body when the pH drops?

    <p>The concentration of H+ ions increases.</p> Signup and view all the answers

    What is the relationship between the concentration of CO2 and the concentration of H+ ions in the bloodstream?

    <p>The concentration of CO2 is directly proportional to the concentration of H+ ions.</p> Signup and view all the answers

    Which of the following is a type of buffering system that involves the exchange of ions between cells?

    <p>Cellular ion exchange buffering system.</p> Signup and view all the answers

    What is the primary cause of respiratory acidosis?

    <p>Elevation of pCO2 due to ventilation depression</p> Signup and view all the answers

    What is the primary mechanism by which proteins function as buffers in the body?

    <p>By binding to H+ ions through their negative charges</p> Signup and view all the answers

    What is the primary difference between respiratory and metabolic alkalosis?

    <p>Respiratory alkalosis is caused by hyperventilation, while metabolic alkalosis is caused by excessive loss of metabolic acids (e.g. chloride)</p> Signup and view all the answers

    What is the effect of hyperaldosteronism with hypokalemia on acid-base balance?

    <p>It leads to metabolic alkalosis</p> Signup and view all the answers

    What is the primary function of bicarbonate in the regulation of acid-base balance?

    <p>To buffer excess H+ ions in the bloodstream</p> Signup and view all the answers

    What is the primary difference between carbonic acid-bicarbonate buffering and protein buffering?

    <p>Carbonic acid-bicarbonate buffering occurs in the ECF, while protein buffering occurs in the ICF with Hgb and in the ECF</p> Signup and view all the answers

    What is the effect of hyperaldosteronism with hypokalemia on acid-base balance?

    <p>It leads to metabolic alkalosis</p> Signup and view all the answers

    What is the role of respiratory and renal buffering mechanisms in maintaining stable pH levels in the body?

    <p>They support and complement the carbonic acid-bicarbonate buffering system by adjusting CO2 levels and ion concentrations</p> Signup and view all the answers

    What kind of buffering mechanisms directly involve the equilibrium between H2CO3, HCO3^-, and H^+?

    <p>Carbonic acid-bicarbonate buffering</p> Signup and view all the answers

    What is the primary extracellular buffer system in the human body?

    <p>Carbonic acid-bicarbonate buffer system</p> Signup and view all the answers

    What happens to the formation of carbonic acid when the partial pressure of CO2 increases?

    <p>It increases</p> Signup and view all the answers

    What are the end products of protein, carbs, and fat metabolism?

    <p>Acids</p> Signup and view all the answers

    What is pH a measure of?

    <p>The negative log of the H+ ion concentration</p> Signup and view all the answers

    What is the relationship between bicarbonate and chloride?

    <p>Bicarbonate is inversely proportional to chloride</p> Signup and view all the answers

    What is the chloride shift?

    <p>The movement of chloride ions out of red blood cells in exchange for bicarbonate ions</p> Signup and view all the answers

    What is renal compensation in relation to acid-base balance?

    <p>Producing acidic or alkaline urine</p> Signup and view all the answers

    What is the definition of metabolic acidosis?

    <p>Depression of bicarbonate levels or an elevation in noncarbonic acids</p> Signup and view all the answers

    What is the compensation mechanism for metabolic acidosis?

    <p>Hyperventilation and renal excretion of excess acid</p> Signup and view all the answers

    What is the anion gap used for?

    <p>Diagnosing and monitoring metabolic acidosis</p> Signup and view all the answers

    What are the possible causes of metabolic acidosis with a high anion gap?

    <p>Diabetic ketoacidosis, lactic acidosis, and toxic ingestions</p> Signup and view all the answers

    What is the major cause of metabolic acidosis with a normal anion gap (hyperchloremic - bicarb loss)?

    <p>All of the above</p> Signup and view all the answers

    How does excess vomiting cause metabolic alkalosis?

    <p>All of the above</p> Signup and view all the answers

    How do hypermetabolic states result in respiratory alkalosis?

    <p>Increase in CO2 production secondary to increased metabolism stimulates the respiratory center, leading to rapid breathing and increased exhalation of CO2</p> Signup and view all the answers

    What are mixed acid-base disorders?

    <p>Disorders that involve a combination of metabolic and respiratory acid-base disturbances</p> Signup and view all the answers

    What is the characteristic of mixed acid-base disorders in terms of compensation?

    <p>Compensation occurs with alteration in PaCO2 and bicarbonate with a normal pH</p> Signup and view all the answers

    What is the effect of acidosis on the potency of local anesthetics?

    <p>It decreases their potency.</p> Signup and view all the answers

    What type of acid-base disorder is caused by salicylate intoxication and high altitudes?

    <p>Respiratory alkalosis</p> Signup and view all the answers

    What is the primary treatment for metabolic alkalosis?

    <p>Administer sodium chloride</p> Signup and view all the answers

    What does the MUDPILES pneumonic stand for to recall the common causes of high anion gap acidosis?

    <p>M - Methanol, U - Uremia, D - Diabetic ketoacidosis, P - Propylene glycol, I - Iron, L - Lactic acidosis, E - Ethylene glycol, S - Salicylates</p> Signup and view all the answers

    In a normal situation, which statement is true about anions and cations?

    <p>Anions should equal cations</p> Signup and view all the answers

    What is the primary mechanism by which metabolic acidosis causes a decrease in pH?

    <p>Noncarbonic acids increase or bicarbonate is lost from the ECF and cannot be regenerated by the kidney</p> Signup and view all the answers

    How can carbonic acid be eliminated?

    <p>As CO2 in the lungs</p> Signup and view all the answers

    When CO2 diffuses into RBCs, what is the resulting product?

    <p>H2CO3 (carbonic acid)</p> Signup and view all the answers

    Carbonic acid in RBCs dissociates into what products?

    <p>H+ and HCO3- (bicarb)</p> Signup and view all the answers

    How are H+ and bicarbonate buffered in RBCs?

    <p>Bicarb moves out of the cell into plasma and is exchanged for Cl-</p> Signup and view all the answers

    Study Notes

    Acid-Base Balance

    • pH is the negative log of the H+ ion concentration
    • To maintain the body's normal pH, H+ must be neutralized by bicarb or excreted
    • Bone, lungs, and kidneys are involved in the regulation of acid-base balance

    Acids and Bases

    • Acids are end products of protein, carbs, and fat metabolism
    • pH below 6.8 is fatal, above 7.8 is fatal
    • pH = -[logH+]
    • Acid-base balance is mainly concerned with H+ and HCO3-

    Carbonic Acid and Bicarbonate Buffering

    • Carbonic acid is volatile and can be eliminated as CO2 in lungs
    • CO2 diffuses into the bloodstream, reacting with H2O to form H2CO3
    • The ratio of bicarb to carbonic acid is 20:1 at pH 7.4
    • Lungs can decrease carbonic acid, while kidneys can reabsorb or regenerate bicarb
    • Bicarb is inversely proportional with chloride

    Buffering Systems

    • Buffer = chemical that can bind excessive H+ or OH- without a significant change in pH
    • Buffer system is located in ICF and ECF
    • Consists of a weak acid and its conjugate base
    • 4 types of buffering systems: carbonic acid-bicarbonate, protein buffering, respiratory/renal buffering, and cellular ion exchange

    Protein Buffering

    • Proteins have negative charges and can buffer H+
    • Mainly intracellular buffer with hemoglobin

    Respiratory and Renal Buffering

    • Respiratory buffering: academia causes increased ventilation, while alkalosis slows respirations
    • Renal buffering: secretion of H+ in urine and reabsorption of bicarb, dibasic phosphate, and ammonia

    Cellular Ion Exchange Buffering

    • Exchange of K+ for H+ in acidosis and alkalosis
    • Important in maintaining acid-base balance

    Acid-Base Imbalances

    • Acidosis: pH < 7.35, due to systemic increase in H+ or excess acid
    • Alkalosis: pH > 7.45, due to systemic decrease in H+ or excess base

    Types of Acid-Base Imbalances

    • Respiratory acidosis: elevation of pCO2 due to ventilation depression
    • Respiratory alkalosis: depression of pCO2 due to hyperventilation
    • Metabolic acidosis: depression of bicarb or an elevation in noncarbonic acids
    • Metabolic alkalosis: elevation of bicarb usually due to excessive loss of metabolic acids

    Metabolic Acidosis

    • Causes: prolonged vomiting, gastric suctioning, excessive bicarb intake, hyperaldosteronism with hypokalemia, diuretic therapy
    • Bicarb is increased due to excessive loss of metabolic acids (e.g. chloride)
    • Manifestations: weakness, muscle cramps, hyperactive reflexes with signs of hypocalcemia
    • Treatment: sodium chloride, potassium, chloride

    Acid-Base Balance

    • pH is the negative log of the H+ ion concentration
    • To maintain the body's normal pH, H+ must be neutralized by bicarb or excreted
    • Bone, lungs, and kidneys are involved in the regulation of acid-base balance

    Acids and Bases

    • Acids are end products of protein, carbs, and fat metabolism
    • pH below 6.8 is fatal, above 7.8 is fatal
    • pH = -[logH+]
    • Acid-base balance is mainly concerned with H+ and HCO3-

    Carbonic Acid and Bicarbonate Buffering

    • Carbonic acid is volatile and can be eliminated as CO2 in lungs
    • CO2 diffuses into the bloodstream, reacting with H2O to form H2CO3
    • The ratio of bicarb to carbonic acid is 20:1 at pH 7.4
    • Lungs can decrease carbonic acid, while kidneys can reabsorb or regenerate bicarb
    • Bicarb is inversely proportional with chloride

    Buffering Systems

    • Buffer = chemical that can bind excessive H+ or OH- without a significant change in pH
    • Buffer system is located in ICF and ECF
    • Consists of a weak acid and its conjugate base
    • 4 types of buffering systems: carbonic acid-bicarbonate, protein buffering, respiratory/renal buffering, and cellular ion exchange

    Protein Buffering

    • Proteins have negative charges and can buffer H+
    • Mainly intracellular buffer with hemoglobin

    Respiratory and Renal Buffering

    • Respiratory buffering: academia causes increased ventilation, while alkalosis slows respirations
    • Renal buffering: secretion of H+ in urine and reabsorption of bicarb, dibasic phosphate, and ammonia

    Cellular Ion Exchange Buffering

    • Exchange of K+ for H+ in acidosis and alkalosis
    • Important in maintaining acid-base balance

    Acid-Base Imbalances

    • Acidosis: pH < 7.35, due to systemic increase in H+ or excess acid
    • Alkalosis: pH > 7.45, due to systemic decrease in H+ or excess base

    Types of Acid-Base Imbalances

    • Respiratory acidosis: elevation of pCO2 due to ventilation depression
    • Respiratory alkalosis: depression of pCO2 due to hyperventilation
    • Metabolic acidosis: depression of bicarb or an elevation in noncarbonic acids
    • Metabolic alkalosis: elevation of bicarb usually due to excessive loss of metabolic acids

    Metabolic Acidosis

    • Causes: prolonged vomiting, gastric suctioning, excessive bicarb intake, hyperaldosteronism with hypokalemia, diuretic therapy
    • Bicarb is increased due to excessive loss of metabolic acids (e.g. chloride)
    • Manifestations: weakness, muscle cramps, hyperactive reflexes with signs of hypocalcemia
    • Treatment: sodium chloride, potassium, chloride

    Acid-Base Balance

    • pH is the negative log of the H+ ion concentration
    • To maintain the body's normal pH, H+ must be neutralized by bicarb or excreted
    • Bone, lungs, and kidneys are involved in the regulation of acid-base balance

    Acids and Bases

    • Acids are end products of protein, carbs, and fat metabolism
    • pH below 6.8 is fatal, above 7.8 is fatal
    • pH = -[logH+]
    • Acid-base balance is mainly concerned with H+ and HCO3-

    Carbonic Acid and Bicarbonate Buffering

    • Carbonic acid is volatile and can be eliminated as CO2 in lungs
    • CO2 diffuses into the bloodstream, reacting with H2O to form H2CO3
    • The ratio of bicarb to carbonic acid is 20:1 at pH 7.4
    • Lungs can decrease carbonic acid, while kidneys can reabsorb or regenerate bicarb
    • Bicarb is inversely proportional with chloride

    Buffering Systems

    • Buffer = chemical that can bind excessive H+ or OH- without a significant change in pH
    • Buffer system is located in ICF and ECF
    • Consists of a weak acid and its conjugate base
    • 4 types of buffering systems: carbonic acid-bicarbonate, protein buffering, respiratory/renal buffering, and cellular ion exchange

    Protein Buffering

    • Proteins have negative charges and can buffer H+
    • Mainly intracellular buffer with hemoglobin

    Respiratory and Renal Buffering

    • Respiratory buffering: academia causes increased ventilation, while alkalosis slows respirations
    • Renal buffering: secretion of H+ in urine and reabsorption of bicarb, dibasic phosphate, and ammonia

    Cellular Ion Exchange Buffering

    • Exchange of K+ for H+ in acidosis and alkalosis
    • Important in maintaining acid-base balance

    Acid-Base Imbalances

    • Acidosis: pH < 7.35, due to systemic increase in H+ or excess acid
    • Alkalosis: pH > 7.45, due to systemic decrease in H+ or excess base

    Types of Acid-Base Imbalances

    • Respiratory acidosis: elevation of pCO2 due to ventilation depression
    • Respiratory alkalosis: depression of pCO2 due to hyperventilation
    • Metabolic acidosis: depression of bicarb or an elevation in noncarbonic acids
    • Metabolic alkalosis: elevation of bicarb usually due to excessive loss of metabolic acids

    Metabolic Acidosis

    • Causes: prolonged vomiting, gastric suctioning, excessive bicarb intake, hyperaldosteronism with hypokalemia, diuretic therapy
    • Bicarb is increased due to excessive loss of metabolic acids (e.g. chloride)
    • Manifestations: weakness, muscle cramps, hyperactive reflexes with signs of hypocalcemia
    • Treatment: sodium chloride, potassium, chloride

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    Description

    This quiz covers the concepts of acid-base balance, pH regulation, and the roles of different organs in maintaining the body's normal pH. It also touches on the basics of acids and bases, and carbonic acid and bicarbonate buffering.

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