patho acid base

what is the normal ph range?

7.35-7.45

what is the most common base in the body

bicarbonate (hco3)

what is the common acid in the body

carbonic acid (h2co3)

What is the normal healthy ration for base and acid in the body

1 carbonic acid to 20 bicarbonate

what is the relation between kidneys, lungs and pH balance?

kidney function = bicarbonate levels

lung function - carbon dioxide levels

How are free Hydrogen ions (H+) and Carbon Dioxide (CO2) directly related to one another?

• carbon dioxide forms carbonic acid

• when carbonic acid dissociates

• whne there is high CO2, there is a shift to make hydrogen ion production

• then in HIGH h+ it shifts left

• DIRECTLY related

• 
  

what are the sources for acid and bases

• carbs excreted by the lungs

• protein metabolism forms sulfuric acid

• fat metabolism forms fatty acids and ketoacids

what is the lungs ph buffering?

• when you hyperventilated (give away alot of acid), you become basic

• when you hyperventilate, you retain alot of CO2 so you become more acidic

what is the neurochemical respiratory control system?

• decreased rhythm rate (hypoventilation) means more h+, this stimulates the central chemoreceptors and makes the body increase the rate and breath.

• then the inhibition continues the cycle

what is renal pH buffering?

distal tubules help kidneys regulate acid base balance

what do the kidneys do to do buffering

pee out h+ ions

reaborbs bicabonate back into the blood

why would you pee out h+ ?

the body is in a state of acidosis

if you are in a state of alkalosis, what will the kidneys do? acidosis?

keep the h+ ions (reabsorb back in the blood)

pee out the base (hco3)

acidosis?

• the opposite

  • keep hco3 and pee out h+

How do Potassium and H+ go together in ECF and ICF cellular buffering

in normal conditions, in the cell potassium levels are greater than out of the cell potassium levels

how does potassium and h+ change within the acidosis?

more h+ ions move into the cell and the K+ ions move out the other cells which cause hyperkalemia

how does potassium and h+ change within alkalosis?

hydrogen are more outside of the cell while k+ move into the intracellular fluid

hypokalemia

how does DKA relate to this icf and ecf within acid base?

if a patient has acidosis, insulin therapy will drive k+ into the cell (which can cause hypokalemia)

the lungs will _________ its effort to blow off more ______ to help _____ blood ph. too much h+ in the body

increase

blow off

more

the lungs will ______ rr and dept of the body is in a state of alkalosis?

decrease

ph levels

7.35-7.45

po2

80-100

pco2

35-45

hco3

22-26

what is respiratory acidosis?

only CO2 problem!!!

excess CO2 in the blood

what is the causes for respiratory hypoventilation?

opioids, head trauma, paralysis of respiratory muscles, inadequate ventilation, PE, obstructive sleep apnea

what are the clinical manifestations of respiratory acidosis?

headache, blurred vision, breathlessness, apprehension,

• restore adequate ventilation

• remove excess co2

what is respiratory alkalosis?

h2co3

• blood ph higher than 7.45

• paco2 less than 35 mmhg

what are the reason for respiratory alkalosis?

anxiety and high altitudes

what are the clinical manifestations of respiratory alkalosis?

tingling of extremities, nausea, tachycardia, and chest pain

what is the metabolic acidosis?

concentration of non carbonic acids

loss of bicarbonate from ecf

less than 7.35 and less than hco3 for 22mmhg

what are the causes of metabolis acidosis?

DKA

poor perfusion because of lactic acid buildup

starvation

diaherra - loss BICARB OUT UR BUTT

what are the clinical manifestations of metabolic acidosis?

kussmaul respirations

• This respiratory attempt decreases CO2 (H+)

  and carbonic acid, which decreases body’s

  overall amount of acids = increases pH.

what is metabolic alkalosis?

blood pH is greater than 7.45

hco3 greater than 26 mmhg

• HIgh BICARBONATE

what are the causes for metabolic alkalosis?

excessive intake of bicarbonate

loop diuretics (potassium wasting)

vomiting (H+ loss)

how do loop diuretics contribute to metabolic alkalosis?

loop diuretics waste potassium so more bicarb is being retained in the blood and not lost in the urine

• h_+ moves out of the cell and into the blood and K moves into the cell (which means less is in the ECF) means more h+ is being wasted so that increases blood pH and bicarbonate

what are the clinical manifestations of metabolic alkalosis?

• weakness

• muscle cramps

• hyperactive reflexes

• tetany

why does metabolic alkalosis contribute to tetany ?

okay so during alkalosis, the blood pH is raised meaning that not enough h= ions are available.

normally, h+ and calcium bind on albumin so since there is not enough h+, the albumin draws more calcium to the blinding sites

the decreased ionized calcium increases the neuromuscular excitability so its easier to activate

when you have metabolic alkalosis, are you hypocalcimic or hyper calcimic

hypo because the calcium in the body is in a different form that is not usable

what are key signs for hypo calcemia?

chvostks isgn - spams of lip and face

trousseaus - carpal

uncompasted

• one normal value

partially compensation

all 3 values are out of range

fully compensated

normal pH, other 2 are abnormal

• pH is NORMALLLL