Term
| Compared with other ions, the concentration of __ in body fluids is usually kept at a very low level and is regulated with extreme precision. |
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Definition
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Term
| The concentration of what ion is essential to the activity of almost all enzymes in the body |
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Definition
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Term
| Substances that release H+ ion in solution |
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Definition
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Term
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Definition
HCl-
Carbonic Acid (H2CO3) |
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Term
| Ions that can accept an H+ ion in solution |
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Definition
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Term
| Give an example of a base. |
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Definition
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Term
| Some proteins can function as a base because some of the amino acids are __ charged and readily accept H+ (hemoglobin) |
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Definition
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Term
| What is another term that is synonymously used with BASE |
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Definition
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Term
| A molecule formed by the combination of one or more alkaline metals (Na, K, Li) with a hydroxyl ion (OH-) |
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Definition
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Term
| The base portion reacts quickly with __ to remove it from solution |
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Definition
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Term
| Excess removal of H+ from body fluids |
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Definition
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Term
| Excess addition of H+ to body fluids |
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Definition
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Term
| This ion readily accepts an H+ to have H2O |
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Definition
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Term
| Name 4 causes to gain of H+ |
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Definition
1. Generation of hydrogen ions from CO2
2. Production of nonvolatile acids from the metabolism of proteins and other organic molecules
3. Gain of H+ ions due to loss of bicarbonate in diarrhea of other nongastric GI fluids
4. Gain of H+ ions due to loss of bicarbonate in the urine |
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Term
| Name 4 causes to loss of H+ |
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Definition
1. Utilization of H+ ions in the metabolism of various organic anions
2. Loss of H+ ions in vomit
3. Loss of H+ ions in the urine
4. Hyperventilation |
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Term
| Name the 3 primary systems that regulate the H+ concentration of body fluids to prevent acidosis or alkalosis |
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Definition
1. Chemical acid-base buffer system
2. Respiratory Regulation of Acid-Base Balance
3. Renal Conrol of Acid-Base Balance |
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Term
| This system reacts within seconds to minimize changes in H+ concentration. |
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Definition
| Chemical acid-base buffer system |
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Term
| This system does not eliminate H+ from or add to the body, but only keep them tied up until balance can be re-established. |
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Definition
| Chemical acid-base buffer system |
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Term
| Any substance that can reversibly bind to H+ |
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Definition
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Term
| When H+ concentration increases, __ H+ bind to the buffer as long as the buffer is available. |
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Definition
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Term
| When the H+ concentration __, H+ is released from the buffer. |
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Definition
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Term
| This system helps to account for daily changes in H+ production with digestion or metabolism |
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Definition
| Chemical acid-base buffer system |
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Term
| The major buffering system of ECF |
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Definition
| Bicarbonate Buffer System |
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Term
| The major ICF and renal tubular buffering system |
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Definition
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Term
| The most plentiful buffer in the body because of high concentrations, especially in cells |
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Definition
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Term
| When a strong base is added (NaOH), the incresed OH- if buffered by H2CO3 and forms what? |
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Definition
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Term
| This buffer system consists of a water solution with a weak acid (H2CO3) and a bicarbonate salt (such as NaHCO3) |
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Definition
Bicarbonate Buffer System
CO2 + H2O <-> H2CO3 <-> HCO3 + H+ |
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Term
| When a strong acid is added (HCl-), the increased H+ is buffered by ___ and forms __, driving the equation to the left. This __ the production of CO2 and H20. The excess CO2 stimulates respiration, which eliminates the CO2 from the ECF. |
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Definition
Bicarbonate
H2CO3
Increases |
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Term
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Definition
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Term
| When additional HCO3- is formed, the resultant decrease in H2CO3 drives the equation to the right and ___ CO2 to form additional H2CO3. |
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Definition
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Term
| When there is a net result of low CO2, this inhibits respiration and CO2 respiration. The rise in HCO3- that occurs is compensated for by increased what? |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| What is the equation for the Bicarbonate Buffer System |
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Definition
| CO2 + H2O <-> H2CO3 <-> HCO3 + H+ |
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Term
| What is the equation for the Phosphate Buffer System |
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Definition
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Term
| With this buffer system, the intracellular pH changes approximately in proportion to ECF pH because rapid diffusion of CO2 across the cell membranes |
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Definition
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Term
| In RBCs, what is the more important buffer? |
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Definition
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Term
| What is the equation of the Protein Buffer System in RBCs |
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Definition
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Term
| Do the buffer systems usually work together or separate? |
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Definition
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Term
| When there is a change in ECF H+, the balance of all the systems changes at the same time |
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Definition
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Term
| Regulates the removal of CO2, and therefore H2CO3, from the ECF |
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Definition
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Term
| This system acts within a few minutes to eliminate CO2, and therefore carbonic acid, from the body |
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Definition
| Respiratory Regulation of Acid-Base Balance |
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Term
| Ventilation rate can be altered by changes in __ and/or __ concentration |
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Definition
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Term
| Decreased CO2 = __ H+ = __ pH |
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Definition
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Term
| Name 2 causes of decreased PCO2 |
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Definition
1. Decreased rate of cellular metabolism (metabolic CO2 formation)
2. PCO2 can also be decreased with increased ventilation |
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Term
| Decreased H+ inhibites what |
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Definition
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Term
| Increased CO2 = __ H+ = __ pH |
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Definition
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Term
| Name 2 causes for increased PCO2 |
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Definition
1. Increase in the rate of cellular metabolism (metabolic CO2 formation)
2. Decreased ventilation |
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Term
| Increased H+ stimulates what? |
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Definition
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Term
| The Respiratoy Regulation of Acid-Base Balance is a negative feedback loop. So if you have an increased H+ = __ alveolar ventilation = __ PCO2 = __ H+ |
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Definition
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Term
| Can excrete either acid or alkaline urine and adjust the ECF H+ concentration toward normal = Eliminate excess acid or base from the body |
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Definition
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Term
| This system is slower to respond. Take a period of hours to days. It is a very powerful regulator of the acid-base system. |
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Definition
| Renal Control of Acid-Base Balance |
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Term
| Under normal circumstances, the kidneys filter 4320 mEq of __ per day. |
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Definition
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Term
| Almost all of ___ filtered is reabsorbed from the tubules in order to conserve the primary buffering system of the ECF |
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Definition
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Term
| In order for bicarbonate to be reabsorbed, it must first react with __ to form __. Therefore, an equivalent amount of __ must be secreted into the tubules to reabsorb the filtered bicarbonate. |
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Definition
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Term
| If there is excess H+ secreted what happens to it? |
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Definition
| It is excreted in the urine |
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Term
| When there is alkalosis, the kidneys fail to reabsorb all the filtered bicarbonate, thereby __ the excretion of bicarbonate. |
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Definition
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Term
| When there is alkalosis, the loss of bicarb translates into an inability to buffer __ in the ECF, so the effect is the same as adding _ to the ECF. |
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Definition
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Term
| When there is alkalosis, the removal of bicarbonate raises the ECF H+ back toward __ |
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Definition
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Term
| When there is acidosis the kidneys do not excrete bicarbonate in the urine but reabsorb all the filtered bicarbonate, which is added back to the ECF. This reduced __ back toward __ |
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Definition
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Term
| Name the 3 fundamental mechanisms of renal regulation of acid-base balance. |
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Definition
1. Tubular secretion of H+
2. Tubular reabsorption of HCO3-
3. Production of new HCO3- |
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Term
| 80-90% of H+ is secreted in the __ __, secreted by sodium-hydrogen counter-transport (early tubular segments) and hydrogen-transporting ATPase (late distal and collecting tubules) |
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Definition
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Term
| 80-90% of HCO3- reabsorption occurs where? |
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Definition
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Term
| HCO3- combines with the secreted H+ to form ___, which dissociates into CO2 and H2O. The CO2 diffuses into the tubular cell. It combines with H2O to form __, which dissociates into HCO3- and H+ |
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Definition
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Term
| H+ can be secreted again and the new HCO3- diffuses into the renal intersitium (reabsorption). The movement of HCO3- into the interstitium is facilitated by a ____ co-transport in the proximal tubules, and ___ in the late segments of the prox tubule, thick ascending loop of henle, and collecting tubules and ducts. |
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Definition
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Term
| The net result for tubular reabsorption of HCO3- is that for every H+ secreted into the tubular lumen, a __ enters the blood. |
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Definition
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Term
| When H+ is secreted in excess of filtered bicarbonate, the majority of it must be buffered for what? |
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Definition
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Term
| Excess H+ can be buffered by _ to form __ and excreted as a sodium salt. |
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Definition
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Term
| The key buffer in tubular fluid, because most filtered phosphates are reabsorbed. |
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Definition
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Term
| Whenever a secreted H+ combines with a buffe other than HCO3-, the net affect ist he addition of 1 new __ to the blood |
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Definition
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Term
| For each NH4 excreted, a new __ is generated and added to the blood. |
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Definition
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Term
| A decreased acidity in the blood pH >7.45 caused by excessive ventilation by the lungs. |
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Definition
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Term
| How common is respiratory alkalosis? |
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Definition
| Rare because of physical pathological conditions |
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Term
| This can occur when a person ascends to high altitude. Low CO2 content stimulates respiration, which causes loss of CO2. |
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Definition
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Term
| Name 2 compensatory responses of Respiratory Alkalosis |
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Definition
1. Chemical Buffers of the body fluids
2. Kidneys increase HCO3 excretion (so that CO2 production will increase) |
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Term
| A condition in which there is decreased respiration that causes an increase in blood CO2 and decreased pH. |
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Definition
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Term
| Respiratory acidosis causes and increase in __ and __ concentrations |
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Definition
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Term
| Can occur from pathological conditions that damage the respiratory centers or that decrease the ability of the lung to eliminate CO2. |
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Definition
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Term
| Can damage to the medulla cause respiratory acidosis? |
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Definition
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Term
| Obstruction of passageways of the respiratory tract, pneumnia, emphysema, decreased pulmonary membrane surface area, or any other factors that interfere with gas exchange between blood and alveolar sac can cause what? |
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Definition
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Term
| Na 2 compensatory techniques for respiratory acidosis. |
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Definition
1. Buffers of the body fluids
2. Kidneys (increase production of HCO3) |
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Term
| A condition that occurs when the body produces too much acid or when the kidneys are not removing enough acid from the body. |
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Definition
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Term
| This refers to all other types of acidosis that are not cause by ecess CO2 in the body fluids |
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Definition
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Term
| Name 4 typical causes of metabolic acidosis. |
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Definition
1. Failure of kidneys to excrete metabolic acids normally found in body
2. Formation of excess metabolic acids in the body
3. Addition of metabolic acids to the body by ingestion or infusion of acids
4. Loss of base from body fluids |
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Term
| How might you have a loss of base from body fluids? |
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Definition
| Diarrhea - intestinal contents |
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Term
| Name 5 common conditions that cause metabolic acidosis. |
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Definition
1. Diarrhea
2. Vomiting of intestinal contents
3. Diabetes mellitus
4. Ingestion of acids
5. Chronic renal failure |
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Term
| Name 2 compensatory responses for metabolic acidosis |
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Definition
1. Buffers of the body fluids
2. Kidneys increase production of HCO3 |
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Term
| Caused by excess retention of HCO3 or loss of H+ from the body. |
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Definition
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Term
| Metabolic acidosis is not neary as common as __ but more common than ___ |
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Definition
Metabolic acidosis
Respiratory alkalosis |
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Term
| Name 4 common causes of metabolic alkalosis |
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Definition
1. Administration of diuretics
2. Excess aldosterone
3. Vomiting of gastric contents
4. Ingestion of alkaline drugs |
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Term
| What is the best treatment for alkalosis or acidosis? |
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Definition
| Correct the condition that caused the abnormality |
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Term
| How might you neutralize excess acid? |
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Definition
| Large amounts of sodium bicarbonate can be ingested by mouth or administered IV |
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Term
| How might you treat alkalosis? |
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Definition
| Ammonium chloride can be administered by mout. It is converted by the liver into urea which liberates HCl |
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Term
| Can result in a patient with acute HCO3 loss from the GI tract because of diarrhea who also has emphysema |
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Definition
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Term
| Respiratory compensation in primary metabolic conditions is ___hours |
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Definition
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Term
| Metabolic compensation in primary respiratory conditions is __ days |
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Definition
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Term
| Failure of the kidneys to reabsorb glucose. Person will present with normal blood glucose, but high levels of glucose in the urine. Must be ruled out before making a diagnosis of diabetes mellitus. |
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Definition
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Term
| Failure of the kidneys to reabsorb amino acids. Fairly rare and apparently has no major clinical significance. Would result in high lvels of cystine, Glycine, etc in the urine |
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Definition
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Term
| Failure of the kidneys to reabsorb phosphate. No immediate clinical significant of low phosphate in the blood. Long term low levels can cause diminished calcification of the bones which may lead to a type of rickets. |
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Definition
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Term
| Failure of the tubules to secrete hydrogen ions. As a result, large amounts of sodium bicarbonate are continuously lost in the urine. Causes a continuous state of metabolic acidosis. Can be hereditary or the result of tubular damage. |
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Definition
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Term
| Failure of the kidneys to respond to antidiuretic hormone. Can lead to large quantities of dilute urine to be excreted. As long as the person is supplied plenty of water this can be a non-issue, but the person is at risk for dehydration if not properly managed |
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Definition
| Nephrogenic Diabetes Insipidus |
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Term
| A generalized reabsorptive detect of the renal tubules |
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Definition
|
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Term
| Usually associated with increased urinary excretion of virtually all amino acids, glucose, and phosphate. Severe causes involve the inability to reabsorb sodium bicarb, increased excretion of potassium and or calcium, and nephrogenic diabetes insipidus. |
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Definition
|
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Term
| Can be caused by hereditary defects or injury from toxins |
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Definition
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Term
| Characterized by decreased sodium, chloride, and potassium reabsorption in the loops of henle. |
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Definition
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Term
| An autosomal recessive disorder caused by impaired function of membrane channels (cotransporters, potassium channels, chloride channels) |
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Definition
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Term
| This Syndrome leads to increased excretion of Na, H2O, Cl, K, and Ca by the kidneys. Salt and water loss lead to volume depletion, resulting in activation of renin-angiotensin-aldosterone system. Stimulates K and H+ secretion in the tubules, and leads to hypokalemia and metabolic alkalosis. |
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Definition
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