Acid-Base Balance Quiz
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Questions and Answers

What is the normal pH of arterial blood?

7.4

What is the normal variation of pH in arterial blood?

7.35 - 7.45

Which of the following is NOT a major buffer system in the body?

  • Bicarbonate
  • Calcium (correct)
  • Ammonia
  • Phosphate
  • Which of the following conditions leads to a decrease in arterial Pco₂?

    <p>Hyperventilation (D)</p> Signup and view all the answers

    The Henderson-Hasselbalch equation shows that the pH of blood can be determined by which two factors?

    <p>Bicarbonate concentration and PCO₂ (D)</p> Signup and view all the answers

    In metabolic acidosis, the kidneys excrete more H+ than normal.

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

    Which type of acid is primarily produced by the metabolism of carbohydrates and fats?

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

    The respiratory system is the primary mechanism for eliminating excess H+ from the body fluids.

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

    What is the function of the Na-H+ exchanger (NHE) in the kidneys?

    <p>It secretes H+ into the tubular lumen and reabsorbs Na+ into the body</p> Signup and view all the answers

    Hyperkalemia can lead to metabolic acidosis.

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

    Which of the following is NOT a cause of metabolic alkalosis?

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

    The buildup of which substance in the blood is a hallmark of diabetic ketoacidosis (DKA)?

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

    Chronic kidney disease can lead to metabolic acidosis due to impaired excretion of phosphates and ammonia.

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

    What is the most common cause of metabolic acidosis?

    <p>Severe diarrhea</p> Signup and view all the answers

    The primary event in respiratory acidosis is an increase in PCO₂.

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

    What is the compensatory response in metabolic acidosis?

    <p>Decreased PCO₂</p> Signup and view all the answers

    Metabolic alkalosis is more common than metabolic acidosis.

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

    Mixed acid-base disorders involve two or more primary events influencing the acid-base status simultaneously.

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

    Flashcards

    What is pH?

    The measurement of hydrogen ion concentration in a solution, expressed on a logarithmic scale.

    What is acidosis?

    A state where the body fluids are more acidic than normal, with a pH below 7.35.

    What is alkalosis?

    A state where the body fluids are more alkaline than normal, with a pH above 7.45.

    What is buffering?

    The ability of a substance to resist changes in pH when acid or base is added.

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    What is the bicarbonate buffer system?

    The most important buffer in the extracellular fluid (ECF), consisting of bicarbonate (HCO3-) and carbonic acid (H2CO3).

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    What is the phosphate buffer system?

    A buffer system less important in body fluids but plays a major role in renal tubular fluid and within cells.

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    What is the ammonia buffer system?

    A buffer system crucial for establishing urine pH, primarily involving ammonia (NH3).

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    How do proteins act as buffers?

    Proteins, primarily located within cells, contribute significantly to the overall buffering capacity of the body fluids.

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    How do red blood cells act as buffers?

    Red blood cells (RBCs) utilize hemoglobin as a buffer, allowing them to transport CO2 and regulate blood pH.

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    How do the lungs regulate acid-base balance?

    The ability of the lungs to regulate the partial pressure of carbon dioxide (Pco2) in the blood, which is a major component of the bicarbonate buffer system.

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    How do the kidneys regulate acid-base balance?

    The ability of the kidneys to excrete hydrogen ions (H+) and reabsorb bicarbonate (HCO3-), playing a crucial role in maintaining acid-base balance.

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    What is the Henderson-Hasselbalch equation?

    A mathematical equation that describes the relationship between pH, bicarbonate concentration (HCO3-), and partial pressure of carbon dioxide (Pco2).

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    What is respiratory acidosis?

    A condition characterized by a primary decrease in pH, accompanied by an increase in Pco2 and H+ concentration.

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    What as respiratory alkalosis?

    A condition characterized by a primary increase in pH, accompanied by a decrease in Pco2 and H+ concentration.

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    What is metabolic acidosis?

    A condition characterized by a primary decrease in pH, accompanied by a decrease in HCO3- concentration.

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    What is metabolic alkalosis?

    A condition characterized by a primary increase in pH, accompanied by an increase in HCO3- concentration.

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    What is compensation in acid-base balance?

    The process by which the body compensates for acid-base imbalances by adjusting the pH of body fluids.

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    How does the respiratory system compensate for acid-base disorders?

    The ability of the respiratory system to partially adjust for metabolic acid-base disorders by modifying breathing rate and depth.

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    How do the kidneys compensate for acid-base disorders?

    The ability of the kidneys to partially adjust for respiratory acid-base disorders by altering bicarbonate reabsorption and H+ secretion.

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    What are mixed acid-base disorders?

    A situation where two or more independent acid-base disorders are present simultaneously, leading to complex acid-base disturbances.

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    What is chronic kidney disease (CKD) and its relationship to acid-base balance?

    A condition characterized by a decreased ability of the kidneys to excrete acids and reabsorb bicarbonate, often leading to metabolic acidosis.

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    How does diet influence acid-base balance?

    A condition where an individual's diet predominantly features protein, often leading to a net addition of acid to the body and an upregulation of ammonium production to increase H+ excretion.

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    How are potassium and acid-base balance related?

    A disturbance in potassium (K+) balance can frequently accompany acid-base disorders, as K+ shifts between the intracellular and extracellular compartments in response to changes in pH.

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    How can metabolic acidosis cause hyperkalemia?

    Metabolic acidosis can lead to hyperkalemia, as H+ ions accumulate in cells, causing K+ ions to move out into the extracellular fluid to maintain electrical neutrality.

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    How can metabolic alkalosis cause hypokalemia?

    Metabolic alkalosis can cause hypokalemia, as H+ ions are shifted out of cells, leading to K+ ions moving into the cells to balance charges.

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    How does hypokalemia affect renal acid secretion?

    Hypokalemia can stimulate ammonia (NH3) production in the kidneys, which increases H+ secretion and bicarbonate (HCO3-) reabsorption, potentially leading to metabolic alkalosis.

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    How does hyperkalemia affect renal acid secretion?

    Hyperkalemia can impair ammonium (NH4+) reabsorption in the kidneys, decreasing the rate of net renal acid secretion and potentially contributing to metabolic acidosis.

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    Study Notes

    Acid-Base Balance

    • The normal pH range in the body is 7.35 - 7.45
    • This range is crucial for life
    • A difference of ±0.05 from 7.4 is significant,
    • Large deviations from normal range are life-threatening
    • About 80 mEq of H+ are produced each day through ingestion and metabolism
    • There are two principle buffering systems in the body, respiratory and renal.
    • The respiratory system controls CO2 and therefore carbonic acid levels.
    • The renal system controls bicarbonate reabsorption

    Acid and Bases:

    • Strong acids: HCl → H+ + Cl-
    • Strong bases: NaOH → Na+ + OH-
    • Buffers: Hbase H+ + base(Weak acid/base)
    • Example Buffer system: H2CO3 ⇌ H+ + HCO3− (carbonic acid and bicarbonate)

    pH and H+ Concentration in Body Fluids

    • Arterial blood pH: 7.40
    • Venous blood pH: 7.35
    • Interstitial fluid pH: 7.35
    • Intracellular fluid pH range: 6.0-7.4
    • Urine pH range: 4.5 - 8.0
    • Gastric HCl pH: 0.8
    • H+ concentration in these fluids in units of nM (nanomoles/L)

    Buffer Systems

    • Bicarbonate: the most important buffer in ECF
    • Phosphate: not important in body fluids
    • Ammonia:Major role in establishing urine pH
    • Proteins: 60-70% of buffering in body fluids
    • Hemoglobin (in RBC): buffers CO2

    Intracellular Buffering:

    • Proteins within cells provide significant buffering capacity
    • H+ and HCO3- only slightly diffuse into cells
    • CO2 diffuses rapidly into cells
    • ICF responds to changes in ECF pH
    • RBCs use hemoglobin as a buffer; CO2 reacts with water to form carbonic acid, which then dissociates into H+ and HCO3−

    Bicarbonate System

    • H+ + HCO3− ⇌ CO2 + H2O
    • Kidneys regulate HCO3− through H+ excretion
    • Lungs regulate pCO2 through alveolar ventilation

    Henderson-Hasselbalch Equation

    • pH = 6.1 + log ([HCO3-] / (0.03 x Pco2 ))
    • This equation demonstrates the relative contributions of bicarbonate and pCO2 in determining pH

    Clinical Diagnosis of Acid-Base Disorders

    • Three primary variables measured to diagnose acid-base disorders: pH, pCO2, and HCO3−
    • pH < 7.4 is acidosis
    • pH > 7.4 is alkalosis
    • Normal values for: Arterial blood pH (7.37-7.43) and venous blood (7.32-7.38)

    Respiratory Regulation of pCO2

    • Alveolar ventilation is regulated by pH.
    • Increased [H+] increases alveolar ventilation.
    • High alveolar ventilation lowers pCO2; low alveolar ventilation increases pCO2.

    Renal Regulation of pCO2 and HCO3− Excretion

    • Bicarbonate absorption, occurs in different sections of the renal tubules.
    • The kidney regulates acid secretion and reabsorption to create a net acid excretion
    • H+ and HCO3 - are regulated independently.
    • Two major categories of noncarbonate bases (buffers): phosphate and ammonium
    • Phosphate is relatively constant
    • Ammonium is variable to accommodate varying acid excretion needs

    Net Acid Excretion

    • Net acid excretion is equal to the sum of NH4+ excretion and urinary titratable acid.
    • Urinary titratable acid is measured by adding NaOH to the urine until pH becomes 7.4, determining how much acid is buffered.

    Acid-Base Regulation by the Kidney

    • The kidneys are responsible for maintaining acid-base balance by adjusting H+ and HCO3- in either the blood or urine.

    Compensation (for Acid-Base Disorders)

    • Respiratory and renal systems compensate for acid-base imbalances
    • Respiratory compensation for metabolic disturbances occurs in ~30 minutes to 24 hours, and
    • Renal compensation for respiratory disturbances takes ~3 to 5 days

    Mixed Acid-Base Disorders

    • These disorders involve two or more primary events acting together to cause disturbances in the acid-base system.
    • Examples include respiratory acidosis with metabolic alkalosis.

    Common causes of Acid-Base Disorders

    • Respiratory acidosis results from decreased ventilation, causing increased CO2
    • Respiratory alkalosis results from increased ventilation, causing decreased CO2
    • Metabolic acidosis results from excessive acid production or insufficient bicarbonate to neutralize the acid
    • Metabolic alkalosis results from excessive bicarbonate production or loss of acid

    Potassium and Acid-Base Balance

    • Potassium and acid-base imbalances are often noted together.
    • Acid-base disorders can influence levels and distribution of potassium.
    • Hypokalemia can increase H+ secretion and ammonia generation
    • Hyperkalemia can impair NH4 production.

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    Description

    Test your understanding of the acid-base balance in the human body. This quiz covers essential concepts including pH levels, buffering systems, and the roles of respiratory and renal functions. Challenge yourself with questions related to the pH of various bodily fluids and the significance of different acid-base interactions.

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