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Questions and Answers
What is the approximate osmolarity, in mOsm/L, inside a typical cell according to the provided information?
What is the approximate osmolarity, in mOsm/L, inside a typical cell according to the provided information?
Which of the following best describes the effect of a hypertonic solution on a cell?
Which of the following best describes the effect of a hypertonic solution on a cell?
What is the approximate timeframe for complete equilibrium to be achieved throughout the entire body after drinking water, assuming normal fluid handling?
What is the approximate timeframe for complete equilibrium to be achieved throughout the entire body after drinking water, assuming normal fluid handling?
What is the primary factor that dictates changes in cell volume, according to the information provided?
What is the primary factor that dictates changes in cell volume, according to the information provided?
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Which term describes the characteristic of a solution that dictates its effect on cellular volume?
Which term describes the characteristic of a solution that dictates its effect on cellular volume?
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Which of the following conditions can lead to changes in intracellular and extracellular fluid volumes?
Which of the following conditions can lead to changes in intracellular and extracellular fluid volumes?
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How quickly are differences in osmolarity between two compartments corrected in the body, assuming normal fluid handling?
How quickly are differences in osmolarity between two compartments corrected in the body, assuming normal fluid handling?
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In the context of renal physiology, where does glutamine metabolism primarily occur, leading to the production of ammonium and bicarbonate ions?
In the context of renal physiology, where does glutamine metabolism primarily occur, leading to the production of ammonium and bicarbonate ions?
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Which of the following mechanisms is directly responsible for moving newly generated bicarbonate ions from the intercalated cells into the interstitial space during H+ excretion?
Which of the following mechanisms is directly responsible for moving newly generated bicarbonate ions from the intercalated cells into the interstitial space during H+ excretion?
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Under what physiological condition would bicarbonate ions primarily be secreted (eliminated) by the kidneys?
Under what physiological condition would bicarbonate ions primarily be secreted (eliminated) by the kidneys?
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Which specific cells within the collecting duct are responsible for secreting H+ into the urine, contributing to the excretion of buffered H+ and the generation of new bicarbonate?
Which specific cells within the collecting duct are responsible for secreting H+ into the urine, contributing to the excretion of buffered H+ and the generation of new bicarbonate?
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What is the net effect on the blood's alkaline reserve as a result of glutamine metabolism in the proximal convoluted tubule?
What is the net effect on the blood's alkaline reserve as a result of glutamine metabolism in the proximal convoluted tubule?
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What physiological effect directly results from excessive glucose spilling into the urine in individuals with diabetes mellitus?
What physiological effect directly results from excessive glucose spilling into the urine in individuals with diabetes mellitus?
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Which of the following best describes the underlying mechanism leading to polydipsia in diabetes mellitus?
Which of the following best describes the underlying mechanism leading to polydipsia in diabetes mellitus?
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In the context of cellular energy production, what is the primary metabolic fate of carbohydrates, lipids, and proteins?
In the context of cellular energy production, what is the primary metabolic fate of carbohydrates, lipids, and proteins?
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What is the crucial role of insulin in maintaining glucose homeostasis?
What is the crucial role of insulin in maintaining glucose homeostasis?
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How does gestational diabetes mellitus differ from type 1 or type 2 diabetes mellitus?
How does gestational diabetes mellitus differ from type 1 or type 2 diabetes mellitus?
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Which of the following is the most direct physiological consequence of cells being unable to use glucose in cases of uncontrolled diabetes mellitus?
Which of the following is the most direct physiological consequence of cells being unable to use glucose in cases of uncontrolled diabetes mellitus?
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What is the commonality among all forms of diabetes mellitus (DM), regardless of the specific type?
What is the commonality among all forms of diabetes mellitus (DM), regardless of the specific type?
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In the context of energy metabolism, what is the ultimate fate of glucose derived from food or glucose stores in the liver?
In the context of energy metabolism, what is the ultimate fate of glucose derived from food or glucose stores in the liver?
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What is the primary physiological mechanism underlying polyuria in individuals with decompensated diabetes mellitus?
What is the primary physiological mechanism underlying polyuria in individuals with decompensated diabetes mellitus?
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How do intracellular proteins and plasma proteins function within protein buffer systems?
How do intracellular proteins and plasma proteins function within protein buffer systems?
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What happens to carboxyl groups (COOH) when pH rises within a protein buffer system?
What happens to carboxyl groups (COOH) when pH rises within a protein buffer system?
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If the blood pH falls (becomes more acidic), what role do amino groups (NH2) play?
If the blood pH falls (becomes more acidic), what role do amino groups (NH2) play?
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How does respiration contribute to the regulation of $H^+$ concentration in the blood?
How does respiration contribute to the regulation of $H^+$ concentration in the blood?
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During $CO_2$ unloading in the lungs, what occurs in relation to $H^+$ concentration, according to the provided information?
During $CO_2$ unloading in the lungs, what occurs in relation to $H^+$ concentration, according to the provided information?
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How does hypercapnia (rising $P_{CO_2}$ in blood) affect respiratory rate and depth?
How does hypercapnia (rising $P_{CO_2}$ in blood) affect respiratory rate and depth?
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What is the effect of rising plasma $H^+$ (acidosis) on respiration?
What is the effect of rising plasma $H^+$ (acidosis) on respiration?
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What is the primary respiratory response to alkalosis, and how does it affect $H^+$ concentration?
What is the primary respiratory response to alkalosis, and how does it affect $H^+$ concentration?
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What acid-base imbalance is most likely to result from hypoventilation, and why?
What acid-base imbalance is most likely to result from hypoventilation, and why?
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What condition results from the respiratory system's response to hyperventilation?
What condition results from the respiratory system's response to hyperventilation?
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Which metabolic process directly contributes to the production of hydrogen ions ($H^+$) in the body?
Which metabolic process directly contributes to the production of hydrogen ions ($H^+$) in the body?
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The conversion of $CO_2$ to $HCO_3^-$ in the blood leads to the liberation of $H^+$ ions. What significance does this process have in maintaining acid-base balance?
The conversion of $CO_2$ to $HCO_3^-$ in the blood leads to the liberation of $H^+$ ions. What significance does this process have in maintaining acid-base balance?
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What is the primary consequence of acidosis on the central nervous system (CNS)?
What is the primary consequence of acidosis on the central nervous system (CNS)?
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In alkalosis, hyperexcitability of the nervous system can manifest in several ways. Which of the following is a characteristic symptom of alkalosis?
In alkalosis, hyperexcitability of the nervous system can manifest in several ways. Which of the following is a characteristic symptom of alkalosis?
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How do fluctuations in $H^+$ concentration outside the normal range typically affect enzyme activity?
How do fluctuations in $H^+$ concentration outside the normal range typically affect enzyme activity?
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The exchange of $K^+$ and $H^+$ in the kidneys plays a critical role in acid-base balance. What direct effect does this exchange have?
The exchange of $K^+$ and $H^+$ in the kidneys plays a critical role in acid-base balance. What direct effect does this exchange have?
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Which of the following is NOT considered one of the three primary mechanisms by which free hydrogen ions are controlled in the body?
Which of the following is NOT considered one of the three primary mechanisms by which free hydrogen ions are controlled in the body?
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In the context of acid-base balance, how does the brain stem contribute to the regulation of $H^+$ levels?
In the context of acid-base balance, how does the brain stem contribute to the regulation of $H^+$ levels?
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Considering the mechanisms of acid-base balance, which of the following best describes the role of chemical buffer systems?
Considering the mechanisms of acid-base balance, which of the following best describes the role of chemical buffer systems?
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Phosphorus-containing protein breakdown releases phosphoric acid into the extracellular fluid (ECF). What direct consequence does this have?
Phosphorus-containing protein breakdown releases phosphoric acid into the extracellular fluid (ECF). What direct consequence does this have?
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Flashcards
Tonicity
Tonicity
Tonicity describes how a solution affects cell volume based on solute concentration.
Isotonic solution
Isotonic solution
An isotonic solution keeps cell volume unchanged because solute concentration is equal to that inside the cell.
Hypertonic solution
Hypertonic solution
A hypertonic solution causes a cell to shrink due to a higher solute concentration outside the cell.
Hypotonic solution
Hypotonic solution
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Osmolarity
Osmolarity
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Fluid transfer across membranes
Fluid transfer across membranes
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Abnormal fluid conditions
Abnormal fluid conditions
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Dipsogenic DI
Dipsogenic DI
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Gestational DI
Gestational DI
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Role of Glucose
Role of Glucose
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Insulin function
Insulin function
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Diabetes Mellitus (DM)
Diabetes Mellitus (DM)
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Type I Diabetes
Type I Diabetes
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Type II Diabetes
Type II Diabetes
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Polydipsia
Polydipsia
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Polyuria
Polyuria
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Phosphate buffer system
Phosphate buffer system
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Intercalated cells
Intercalated cells
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Glutamine metabolism
Glutamine metabolism
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Bicarbonate ion secretion
Bicarbonate ion secretion
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HCO3-/Cl- exchanger
HCO3-/Cl- exchanger
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Protein buffer system
Protein buffer system
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Amphoteric
Amphoteric
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Hemoglobin as buffer
Hemoglobin as buffer
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Respiratory regulation of H+
Respiratory regulation of H+
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PCO2 and chemoreceptors
PCO2 and chemoreceptors
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Acidosis and chemoreceptors
Acidosis and chemoreceptors
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Respiratory acidosis
Respiratory acidosis
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Respiratory alkalosis
Respiratory alkalosis
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CO2 unloading and H+
CO2 unloading and H+
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Alkalosis effect on respiration
Alkalosis effect on respiration
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H+ Production
H+ Production
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Metabolism By-products
Metabolism By-products
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CO2 and H+ Relationship
CO2 and H+ Relationship
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Blood pH Range
Blood pH Range
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Acidosis
Acidosis
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Alkalosis
Alkalosis
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Enzyme Activity and pH
Enzyme Activity and pH
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Arrhythmias and H+
Arrhythmias and H+
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Acid-Base Balance Mechanisms
Acid-Base Balance Mechanisms
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Chemical Buffer Systems
Chemical Buffer Systems
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Study Notes
Lecture Content
- Lecture 1 covers fluid and electrolyte balance, and acid-base balance.
Evaluation
- Test 1: 20%
- Test 2: 15%
- Wiley Quizzes: 10%
- Labster Assignments: 10% (based on Labster score)
- Final Exam: 40%
Main Topics of Study
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Fluid, electrolyte, and acid-base physiology
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Cardiovascular physiology
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Cardiac and vascular anatomy
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Respiratory physiology
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Lymphatics and immunity
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Independent and hybrid study:
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Cardiac anatomy (some overlap with lectures)
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Blood vasculature anatomy (some overlap with lectures)
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Respiratory anatomy (some overlap with lectures)
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Pregnancy and development - stages of pregnancy and labor
Muddy Points
- Submit any unclear areas via Brightspace.
Case Study 1
- A young male (approximately 25 years old), with insulin-dependent diabetes presents with confusion, irritation, lower abdominal pain, periodic emesis, rapid respiratory rate, hypotension, tachycardia, and fever.
- A fruity breath odor indicates elevated blood glucose (above 600 mg/dL).
- Blood tests reveal hyperkalemia, hypomagnesemia, and increased serum ketones.
- An arterial blood gas analysis shows metabolic acidosis.
- He is diagnosed with diabetic ketoacidosis and treated with IV saline.
Case Study 1 - Questions
- Describe the renal response to metabolic acidosis and respiratory alkalosis?
- What is the expected compensatory response to metabolic acidosis?
- What mechanism explains the patient's report of lower abdominal pain?
- Define hypotensive, tachypneic, and febrile.
- Explain the significance of elevated serum ketones in this case?
- What are the three primary ways plasma acid-base homeostasis is maintained?
- How is metabolic acidosis determined?
- What features distinguish metabolic acidosis from respiratory acidosis?
- Describe at least three physiological outcomes from acute metabolic acidosis?
Fluid Balance - Recap
- This section reviews fluid balance.
Ionie Composition of Major Body Compartment
- Plasma and interstitial fluid are almost identical.
- They are separated by the thin capillary vessel wall.
Total Body Fluid
- Intracellular fluid (ICF) is approximately 40% of total body weight.
- Composition of cellular fluid is similar in different cell types.
- Extracellular fluid (ECF) includes plasma (3L) and interstitial fluid (11L)
- Plasma is the non-cellular portion of blood; it continuously exchanges with IF through capillary membranes.
- Pores are highly permeable to most solutes in ECF except plasma proteins.
- Blood is a separate fluid compartment within the circulatory system; it is approximately 7% of body weight.
- Complete equilibration of drinking water throughout the total body takes approximately 30 minutes.
Insensible Water Loss
- Insensible water loss occurs through the skin (diffusion) - up to 400 mL per day.
Water Balance Disorders
- Dehydration
- Hypotonic hydration
- Edema
Dehydration
- Conditions such as heat, and high metabolism cause excessive water loss.
- Excessive loss of water from ECF increases ECF osmotic pressure.
- Cells respond by losing water, resulting in plasmolysis.
Tonicity and Cell Volume
- Small changes in impermeable solute concentration in ECF cause large changes in cell volume.
- Isotonic solutions have no effect on cell volume.
- Hypertonic solutions cause cell shrinkage.
- Hypotonic solutions cause cell swelling.
Abnormal Fluid Conditions
- Variations in intracellular and extracellular volumes can arise from excessive fluid intake, dehydration, renal dysfunction, vomiting, or hyperhidrosis.
- Water moves faster across cell membranes.
- Cell membranes are mostly impermeable to solutes.
- Two main types of IV fluids are crystalloids and colloids.
- Crystalloids are preferred in most cases.
- Fluid administration is needed in resuscitation, rehydration, and maintenance.
Edema
- Excessive fluid accumulation in the interstitial fluid causes tissue swelling,.
- Cells remain the same size.
The Pensive Paramedic
- Without the Na+/K+ ATPase pump, the ECF becomes hypertonic.
Cellular Swelling
- Excessive water moves into the cell due to cellular injury and is termed hydropic degeneration
- Cells show vacuoles forming within them.
- Cellular injury can lead to hypoxia
- Hypoxia results in a loss of cellular oxygen delivery and leads to less efficient metabolic processes (glycolysis)
- Reduction in ATP production decreases the activity of Na+/K+ ATPase activity and results in intracellular accumulation of Na+ followed by water.
Factors Causing Fluid Imbalance
- Hypovolemia (decrease in total body fluid): Trauma, dehydration, excessive fluid loss, polyuria, high fever.
- Hypervolemia (total body fluid overload): Iatrogenic causes, reduced excretion from renal failure.
- Normovolemia with fluid imbalance: fluid accumulation or loss.
- Localized tissue vasoconstriction and loss of tissue perfusion can lead to multiorgan failure (shock).
Diabetes and Hydration
- Diabetes mellitus (DM) is a group of diseases linked to the inability to produce or utilize insulin and can cause excessive glucose in the blood and urine
- Diabetes insipidus (DI) and diabetes mellitus (DM) are unrelated, although both cause excessive urination.
- Excessive glucose in the urine leads to fluid loss and increased thirst.
- This results in dehydration.
Diabetes Insipidus
- DI is relatively rare; body produces too much urine.
- Symptoms include polyuria and polydipsia.
- It can be central, when the body doesn't make enough ADH/vasopressin.
- It is nephrogenic when the kidneys can't respond to ADH.
- It is dipsogenic, when the hypothalamus continuously stimulates the thirst centers.
- Gestational DI develops temporarily during pregnancy.
Role of Glucose and Insulin
- Cells rely on glucose for primary metabolic fuel.
- Glucose comes from food or liver stores.
- Insulin is required for glucose uptake into cells.
Diabetes Mellitus (Type I)
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Characterized by low insulin
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Immune system destroys pancreatic islet beta cells.
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Commonly develops in young people (<20 years).
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Also known as Juvenile-onset diabetes.
Diabetes Mellitus (Type I) continued
- Symptoms appear after most pancreatic islet beta cells are destroyed.
- Reduced insulin production and utilization of glucose.
- Triglyceride catabolism occurs as a result forcing issues in cardiovascular, peripheral vascular, and cerebral areas.
Diabetes Mellitus (Type II)
- Formerly called non-insulin-dependent diabetes.
- More common than type I.
- Common in obese people >35 years.
- Insulin is produced, but cells are not sensitive to insulin.
- Insulin receptor number is reduced in cells.
- Clinical symptoms are mild, and the condition is usually controlled by diet, exercise, and weight loss.
Acid-Base Balance
- This section describes sources of body acidity.
- Three main chemical buffer systems are highlighted
- Bicarbonate, phosphate, and proteins.
- Respiratory regulation of H+ and its role in acid-base balance is discussed.
- The renal system's mechanism in regulating acid-base balance is detailed, including the generation of new bicarbonate ions and excretion of H+.
Consequences of H+ Fluctuation
- Small changes in H+ have drastic consequences on normal function.
- Acidosis:overall suppression of the CNS (disorientation and coma).
- Alkalosis:hyperexcitability of the nervous system (paraesthesia, muscle twitching, spasms, and seizures).
- Elevated enzyme activity can prevail when outside normal ranges.
- Arrhythmias can occur.
- K+ and H+ are oppositely exchanged in the kidneys.
Determining a Patient's Acid-Base Status
- pH, HCO3, and pCo2 are parameters of blood plasma.
- Compensation occurs if the compensating parameter (bicarbonate or CO2) remains within normal ranges.
- If the compensating variable is outside the normal range, then compensation is evident.
Normal Serum Values
- Normal pH range: 7.35-7.45
- Normal HCO3- range: 22-26 mmol/L
- Normal pCO2 range: 35-45 mm Hg
Respiratory Acidosis and Alkalosis
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PCO2 levels outside of 35-45 mm Hg can indicate inadequate respiratory function
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Respiratory Acidosis:
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PCO2 above 45 mm Hg
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Due to decrease in ventilation or impaired gas exchange
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CO2 accumulates in the blood, causing acidemia
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Respiratory Alkalosis:
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PCO2 below 35 mm Hg
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Common result of hyperventilation
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CO2 is eliminated faster than it is produced, causing alkalemia
Metabolic Acidosis
- Low blood pH and bicarbonate concentration
- Caused by excessive alcohol intake, excessive loss of bicarbonate (persistent diarrhea), or accumulation of lactic acid (exercise/shock, starvation, ketosis in diabetic crisis, or kidney failure).
Metabolic Alkalosis
- Rising blood pH and bicarbonate concentrations.
- Less common than metabolic acidosis.
- Can be caused by excessive vomiting or over-ingestion of antacids.
Muddy Point Reflection
- Students are encouraged to reflect on any unclear areas.
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Description
Test your knowledge on cellular osmolarity and its effects on cell volume. This quiz covers concepts related to hypertonic solutions, changes in fluid volumes, and renal physiology. Assess your understanding of how osmolarity influences cell behavior and fluid dynamics in the body.