Clinical Chem Acid-Base Balance & Electrolytes

bicarbonate buffer system
phosphate buffer system
protein buffer system

What are the three buffer systems in the body

They are solutions that can resist significant changes in pH

What are buffers?

extracellular, lungs, kidneys

Bicarbonate buffer system is a major e_______ buffer system which operates in both _____ and _____

bicarbonate buffer system

which buffer system consists of carbonic acids (H2CO3) as the weak acids and its conjugate bases, bicarbonate ions

carbonic acids, CO2

lungs
decrease the c______ a____ level through exhalation
adjust the respiration rate to decrease or increase the ____

bicarbonate, acidic, alkaline

kidneys
reabsorbs ______ ions or regenerate new _______ ions
produce more _____ or more _____ urine

HbO2

________ is formed from HHb by releasing H+ which will react with HCO3 and form H2CO3 + CO2 + H2

alveolar ventilation

Decreased ________ (hypoventilation) leads to a decrease in the elimination of CO2 from the lungs.

Alkali

________- a base that is soluble in water & produces hydroxyl ion (OH)-

Acid base balance

________ is regulated within a narrow range for normal physiological functions.

H2CO3

________ is formed when dissolved carbon dioxide combines with the water in the bloodstream.

CO2

________ produced by metabolism enters the blood, hydrated to form H2CO3.

Haemoglobin

________ (Hb) is the major intracellular buffer system.

Lungs

________ → decrease the carbonic acids level through exhalation.

Electrolytes

________ are charged atoms or molecules found kn body fluids that are important for.

Chronic respiratory acidosis

________: pH drops 0.05 unit for every 15 mmHg increase in pCO2.

Acute respiratory acidosis

________: pH drops 0.1 unit for every 15 mmHg increase in pCO2.

HbO2

________ accepts the H+ to form HHb.

H2CO3

When hydrogen ions are low, the ________ will donate H+ and turn in to HCO3-

HCO3-

When hydrogen ions are high, ______ will accept H+ to form H2CO3

Acid

proton (H+) donor

Strong acid

low affinity between acids & protons; highly dissociated in aqueous solution

Weak acid

high affinity between acids & protons; poorly dissociated in aqueous solution

Base

proton (H+) acceptor

Alkali

a base that is soluble in water & produces hydroxyl ion (OH-)

Anion gap

the difference between the unmeasured anions and the unmeasured cations

renal tubular, intracellular

Phosphate buffer system is important in buffering r_____ t_____ fluid and i_____ fluid

phosphate buffer system

which buffer system is comprised of hydrogen phosphate ions & dihydrogen phosphate ions

HPO4(2-)

when hydrogen ions are high, ______ will accept H+ to form H2PO4-

H2PO4-

when hydrogen ions are low, ______ will donate H+ and turn in to HPO4(2-)

HPO4(2-)/hydrogen phosphate ion

There is high concentration of __________ intracellularly & in urine

true

Phosphate buffer system is a critical renal & urinary buffer. True or false?

abundant, body fluids

Protein buffer system most ______ and important buffer system in the ______

Haemoglobin, intracellular

H_______ (Hb) is the major i______ buffer system

CO2, H2CO3

_____ produced by metabolism enters the blood, hydrated to form _____

H2CO3

_____ ionises to form H+ & HCO3-

HHb

HbO2 accepts the H+ to form ____

7.35-7.45

Normal blood ph range

It is due to hydrochloric acid

Why is gastric juice pH low?

it is important to maintain digestive function

Why is it important that pancreatic juice more alkaline?

respiratory and non-respiratory acid-base disorder

What are the two types of acid-base imbalance disorder?

ventilatory dysfunction, pCO2

Respiratory acid-base disorder is caused by:
Thus, causing a change in _____

a change in renal or metabolic functions, bicarbonate

metabolic acid-based disorder is caused by:
Thus, causing a change in the ______ level

hypoventilation, a decrease in the elimination of CO2 from the lungs

Respiratory Acidosis is due to:
Thus, causing

increase excretion of H+
increase reabsorption of HCO3-
increase formation of ammonia

How do kidneys help with respiratory acidosis?

increase rate and depth of breathing

How do lungs help with respiratory acidosis?

hyperventilation, excessive elimination of CO2 by the lungs

Respiratory alkalosis is due to:
Thus, causing

Increased bicarbonate secretion

How do kidneys help with respiratory acidosis?

excess loss of bicarbonate ions or increased production of organic acids

Metabolic acidosis is due to:

increase excretion of H+
increase reabsorption of HCO3-
increase formation of ammonia

How do kidneys help with metabolic acidosis?

quick and shallow breathing

How do lungs help with metabolic acidosis?

increase in bicarbonate ions

Metabolic alkalosis is due to:

excrete > HCO3- & form < NH3

How do kidneys help with metabolic alkalosis?

slower and deeper breaths to retain CO2

How do lungs help with metabolic alkalosis?

intracellular and extracellular

Fluid in the body exists in two major compartments:

charged

Electrolytes are _____ atoms or molecules found in body fluids that are important to sustain life

negatively charged

Anions are _____ ions

positively charged

Cations are _____ ions

permeability, nerve

The important roles in electrolytes:
regulation of water distribution, osmotic pressure, cell _____
n____ transmissions to muscles
oxidation-reduction reactions, maintenance of blood pH

diet

Main source of sodium is:

intake of water
excretion of water
excretion of Na+ through aldosterone, angiotensin II & atrial natriuretic peptide (ANP)

3 primary process of regulation of sodium

renin-angiotensis-aldosterone (RAA) system
antidiuretic hormone (ADH)

2 major homeostatic systems of sodium:

increased Na+ loss
increased water retention
water imbalance

hyponatremia is caused by:
- (e.g., prolonged vomiting, diuretic use, severe burns)
- (e.g., renal failure, hepatic cirrhosis, congestive heart failure)
- (e.g., excess water intake)

fluid restriction
hypertonic saline and/or other pharmacologic agents

conventional treatment for hyponatremia:

osmotic demyelination syndrome
cerebral edema

possible complications of hyponatremia:

excess loss of water relative to Na+ loss
decreased water intake
increased Na+ intake or retention (i.e., excess ingestion of salt)

Hypernatremia is caused by:

Chloride/Cl-

______ is involved in maintaining osmolality, blood volume & electric neutrality

glomerulus, proximal

Chloride is filtered out by ______ & passively reabsorbed by the ______ tubules

excess chloride is excreted in the _____ and sweat

proximal, chloride

Chloride maintains electrical neutrality by:

reabsorption of Na+ along with Cl- in _____ renal tubules

Cl- acts as rate-limiting factor or

through ______ shift

ketoacidosis, aldosterone

Hypochloremia due to prolonged vomiting, diabetic _______, _______ deficiency, pyelonephritis

conditions associated with high serum [HCO3-]

Hyperchloremia

________ caused by dehydration, renal tubule acidosis, prolonged diarrhea & diabetes insipidus
excess loss of HCO3-