Term
| What molecules in the blood can be inserted into this equation: pH = [BASE]/[ACID]? |
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Definition
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Term
| What is the normal ratio of [bicarbonate]:[CO2]? |
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Definition
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Term
| Where is the highest proton concentration in the body? |
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Definition
| intracellular because that is where is it produced |
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Term
| In the transfer of protons from intracellular to interstitial space to plasma to excretion, what are the slow processes and what are the fast processes? |
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Definition
slow = H+ transport from intracellular to interstitial because it is difficult to move protons across the cell membrane
fast = H+ transport between IS space and plasma across capillary endothelium |
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Term
| What are normal loads of acids being excreted in the urine? |
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Definition
titratable acid (H2PO4-) = 20 mmol/day
ammonium ion load = 40 mmol/day |
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Term
| How does chronic acidosis affect urine loads of titratable acids and ammonium? |
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Definition
titrable acid (H2PO4-) load doubles
ammonium load quadruples |
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Term
| how does chronic alkalosis affect urine loads of titratable acids and ammonium? |
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Definition
Both fall to 0 and are no longer secreted,
BUT bicarbonate load increases to about 80 mmol/day |
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Term
| What is Kussmaul breathing? |
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Definition
| deep, labored breathing that occurs in chronic acidosis |
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Term
| What is the mechanism of hypokalemic metabolic alkalosis? |
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Definition
- aldosterone stimulates Na/K ATPase which saves Na+ but excretes K+
- protons fill the positive charge depletion in the cells causing intracellular acidosis
- protons are then excreted and HCO3- is reabsorbed leading to alkalosis
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Term
| What is the isohydric principle? |
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Definition
| The isohydric principle is the phenomenon whereby multiple acid/base pairs in solution will be in equilibrium with one another, tied together by their common reagent: the hydrogen ion and hence, the pH of solution. Any condition that changes the balance of one of the buffer systems, also changes the balance of all the others because the buffer systems actually buffer one another by shifting hydrogen ions back and forth from one to the other. |
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Term
| What are the three main arterial blood buffers? |
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Definition
| bicarbonate, hemoglobin, and phosphate |
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Term
| What is the arterial "buffer of choice"? why? |
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Definition
| bicarbonate because it is open to the environment via lungs (CO2) and kidneys |
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Term
| What is the Henderson-Hasselbach equation as applied to bicarbonate? |
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Definition
| pH = 6.1 + log([HCO3-]/(0.03xPaCO2)) |
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Term
| What does 6.1 represent in the Henderson-Hasselbach equation? |
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Definition
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Term
| What does 0.03 represent in the H-H equation? |
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Definition
| it is the conversion factor for converting partial pressure of CO2 to mM of CO2 |
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Term
| What is the equation for the anion gap? |
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Definition
| [A-] (mEq/L) = [Na+] - [HCO3-] - [Cl-] |
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Term
| If you have an acid-base problem and the anion gap is normal, where would the problem likely be? |
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Definition
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Term
| If you have an acid-base problem and the anion gap is high, where would the problem likely be? |
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Definition
| Unmeasured anions floating around like ketoacid or lactic acid |
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