Term
| normal pH of arterial blood: |
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Definition
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Term
| normal pH of venous blood and interstitial fluid: |
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Definition
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Term
| normal pH of intracellular fluid: |
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Definition
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Term
| With alkalosis, aka alkalemia, arterial blood pH __ to above ___, meaning there are ___ hydrogen ions. |
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Definition
- pH raises to above 7.45
- decreased hydrogen ions |
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Term
| With acidosis, aka acidemia, arterial blood pH ___ to below ___, meaning there are ____ hydrogen ions. |
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Definition
- pH drops to below 7.35
- increased hydrogen ions |
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Term
| when referring to alkalosis or acidosis, we are talking about ___ blood. |
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Definition
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Term
| Venous blood is more ___ b/c increased amounts of ___. |
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Definition
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Term
| Most hydrogen ions originate from ___ ___. |
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Definition
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Term
| Hydrogen originates from the following processes involved in cellular metabolism: |
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Definition
- breakdown of phosphorous containing proteins releases phosphoric acid into ECF
- transporting carbon dioxide as bicarbonate releases hydrogen ions
- anaerobic respiration of glucose produces lactic acid
- fat metabolism yiedls organic acids and ketone bodies |
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Term
| Hydrogen ion concentration is regulated sequentially by what three mechanisms: |
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Definition
- chemical buffer system- acts within seconds
- respiratory center in brain stem- acts within 1-3 minutes, regulates frequency and depth of breathing to regulate blood CO2 levels
- renal mechanisms- requires hours to days to effect pH changes |
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Term
| The chemical buffer system is composed of molecules that act to resist pH changes when strong acid or base is added. List the three components of the chemical buffer system. Any drifts in pH are resisted by the ___ ___ buffering system. |
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Definition
- bicarbonate buffer system
- phosphate buffer system
- protein buffer system
- entire chemical buffering system |
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Term
| The chemical buffer system ALWAYS contains a ___ ___ and its ___. Give an example. |
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Definition
- weak acid and its salt
- carbonic acid (H2CO2) and sodium bicarbonate (NaHCO3) are the major buffer system in the intracellular fluid |
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Term
| The ___ buffer system is the most important extracelluar buffer. |
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Definition
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Term
| HCO3-(bicarbonate) and CO2 are regulated by the ___ and ___ respectively. |
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Definition
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Term
| normal ratio of CO2/HCO3- in extracellular fluid : |
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Definition
| 1:24. This ratio helps maintain our arterial pH at 7.4 |
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Term
| The phosphate buffer system is an important ___ fluid buffer and ___ buffer.It is also important for buffering ___. This system is nearly identical to the ___ system. |
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Definition
- intracellular
- urine
- hemoglobin
- bicarbonate |
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Term
| Components of the phosphate buffer system: |
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Definition
- sodium salts of dihydrogen phosphate (H2PO4-), a weak acid
- monohydrogen phosphate (HPO4-2), a weak base |
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Term
| The protein buffer system is made up of ___ and ___ proteins. |
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Definition
| - plasma and intracellular |
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Term
| __ and ___ ___ are the bodies most plentiful and powerful buffers. |
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Definition
| Plasma and intracellular proteins |
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Term
| Some proteins have amino acids that are free organic acid groups that act as a ___ ___, while others have amino acids that act as a ___ ___ due to __ groups. ___ molecules are protein molecules that can function as both a weak acid and a weak base. |
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Definition
- weak acid
- weak base via amino groups
- Amphoteric |
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Term
| The respiratory system regulation of acid base balance is a ____ buffering system. There is a reversible equillibrium b/w dissolved ___ ___ and ___ and ___ ___ and __ and ___ ___. |
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Definition
- physiological
- dissolved CO2 and water
- carbonic acid and hydrogen and bicarbonate ions
CO2 + H2O <> H2CO3 <> H+ + HCO3- |
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Term
| So high levels of CO2, leads to increased ___ __, which leads to increased concentration of ___ ___, which ___ pH. |
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Definition
- carbonic acid
- hydrogen ions
- decreases |
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Term
| During carbon dioxide unloading, hydrogen ions are incorporated into ____. |
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Definition
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Term
| When hypercapnia (increased CO2) or rising plasma H+ occurs, breaths become ___ and ___ __to expel more CO2. This ___ hydrogen ion concentration. |
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Definition
- deeper
- more rapid
- reduces |
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Term
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Definition
| hyperventilation to get rid of excess CO2 |
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Term
| Alkalosis cuases ___, ___ ___ breathing, causing ___ to increase. |
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Definition
- slower, more shallow
- H+ |
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Term
| Respiratory system impairement causes __ ___ ____. |
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Definition
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Term
| Chemical buffers can tie up excess acids or bases, but they cannot ___ them from the body. |
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Definition
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Term
| The lungs can eliminate ___ ___ by eliminating ___ ____. |
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Definition
- carbon dioxide
- carbonic acid |
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Term
| Only the kidneys can rid the body of ___ ___ (phosphoric, uric, lactic, ketones) and prevent metabolic ____. |
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Definition
- metabolic acids
- prevent metabolic acidosis |
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Term
| The ultimate acid-base regulating organs: |
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Definition
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Term
| The most important renal mechanisms for regulating acid-base balance are: |
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Definition
- Conserving via reabsorbing or generating new bicarbonate ions
- Excreting bicarbonate ions |
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Term
| Losing a bicarbonate ion is the same thing as ___ a hydrogen ion. Likewise, reabsorbing a bicarbonate ion is same as ___ a hydrogen ion. |
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Definition
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Term
| Bicarbonate is reabsorbed in ___ ___ of the renal tubules and is always related to ___ ___. |
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Definition
- all sections
- hydrogen secretion |
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Term
| Reabsorption of bicarbonate in the proximal tubule and loop of Henle: ___ ___ formed in filtrate dissociates to release __ __ and ___. __ __ then diffuses into __ __, where it acts to trigger further __ __ ___. |
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Definition
- Carbonic acid
- carbon dioxide and water
- carbon dioxide
- tubule cells
- hydrogen ion secretion |
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Term
| ___ ___, an enzyme in epithelial tubule cells, causes the CO2 to react with ___ to form ___ ___, which then dissociates into ___ ions and ___. They hydrogen ions get __ into the filtrate, while the bicaronate gets absorbed by capillaries. This is how bicarb reabsorption, furthers hydrogen secretions. |
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Definition
- Carbonic anhydrase
- water
- carbonic anhydrase
- hydrogen ions and bicarbonate
- secreted |
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Term
| Go through all steps in sequential order of bicarbonate reabsorption in the proximal tubule and loop of Henle: |
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Definition
- carbonic acid in filtrate > (carbonic anhydrase)> water and CO2> CO2 diffuses into tubule epithelial cells> (carbonic anhydrase and water)> carbonic acid> breaks down into hydrogen ions and bicarbonate> hydrogen ions get secreted into tubule lumen> bicarbonate get reabsorbed by capillaries
(this can happen in tubule cells or epithelial cells) |
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Term
| If the blood is slightly acidic, you will have more ___ ___ so more bicarbonate will be reabsorbed to bring pH back to normal. |
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Definition
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Term
| In the distal tubule _ ___ ___ are the hydrogen secreting cells, while __ ___ ___ are the bicarbonate secreting cells. |
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Definition
- A intercalated cells
- B intercalated cells |
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Term
| Reabsorption of bicarbonate in distal tubule is very similar to mechanism in proximal tubule.Reabsorption of bicarb and secretion of hydrogen here occurs in 1:1 ratio. This occurs in a normal state, but during ___ this mechanism is more acitve. |
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Definition
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Term
| With acidosis, there is a hydrogen ion graident and you want to secrete hydrogen and absorb bicarbonate. So there will be (4): |
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Definition
- hydrogen gradient
- increased activity of transporters
- increased membrane expression of transporters
- long term increase in synthesis of transporters |
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Term
| Hormones involved in regulation of H+ secretion: |
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Definition
- Endothelin-1
- Cortisol
- Angiotensin II
- Aldosterone |
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Term
| Formation of new bicarbonate in the kidneys involves renal excretion of acid via ___ and ___ of ___ ___ (__) or ___ ___ (__). |
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Definition
- titrable acid (phosphate)
- ammonium ions (NH4+) |
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Term
| So to make new bicarbonate the kidneys must secrete and excrete ___ __ and ___ ___. |
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Definition
- titrable acid (phosphate)
- ammonium ions (NH4+) |
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Term
| Hydrogen ion excretions as titrable acids occurs in ___ ___ in response to ___. The kidneys generate ___ ions and add them to blood, while an equal amount of ___ __ are added to the urine. |
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Definition
- intercalated cells
- acidosis
- bicarbonate
- hydrogen ions |
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Term
| In the ___ tubule, each ___ metabolized produces ___ ___ ___ and ___ ___ ___. The ___ moves to the blood and the ___ ___ are excreted in the urine. |
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Definition
- proximal
- glutamine
- 2 ammonium ions
- 2 bicarbonate ions
- bicarbonate
- ammonium ions |
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Term
| ammonium ion excretion happens in the ___ ___ and ___ ___. |
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Definition
proximal tubule
collecting duct |
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Term
| The ascending limb of the loop of Henle is permeable to ___ ___. So ___ __ come of the ascending limb of the loop of henle and into the ___ __, and then into the ___ ___ for excretion. |
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Definition
- ammonium ions
- ammonium ions
- interstitial fluid
- collecting duct |
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Term
| Ammonium ions can be pumped into a collecting duct cell from blood via the ___ __ ___ ____. Likewise, ammonium ions are pumped from the collecting duct cell into the collecting duct lumen via a ___ __ ___ ___ |
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Definition
- ammonium ion hydrogen antiporter.
- ammonium ion hydrogen antiporter |
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Term
| Ammonium ions are formed in the ___ ___ from the metabolism of ___. They get pumped out of the proximal tubule cell and into the tubule lumen by ___ __ ___ ____. |
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Definition
| - ammonium ion sodium antiporters |
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Term
| Secretion of ammonium ions in the proximal tubule and collecting duct is coupled to ___ ___. |
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Definition
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Term
| The major site for secretion of hydrogen and ammonium ions is the ___ ___. |
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Definition
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Term
| When the body is in alkalosis, ___ ___ ___ cells exhibit ___ ___ secretion and ___ ___ ___ to acidify the blood. |
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Definition
- type B intercalated cells
- bicarbonate ion secretion
- reclaim hydrogen ions |
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Term
| The mechanism of type B intercalated cells that secrete bicarbonate and reclaim hydrogen is the opposite of type A intercalated cells. |
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Definition
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Term
| Even duriing alkalosis, the nephrons and collecting ducts conserve more bicarbonate ions than they secrete. |
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Definition
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Term
| 4 types of acid base imbalance: |
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Definition
- metabolic acidosis
- metabolic alkalosis
- respiratory acidosis
- respiratory alkalosis |
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Term
| respiratory acidosis and alkalosis result from: |
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Definition
| failure of the respiratory system to balance pH |
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Term
| ___ is the single most important indicator of respiratory inadequacy. |
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Definition
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Term
| normal PCO2 fluctates between: |
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Definition
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Term
| Values of PCO2 above 45 mmHg indicate: |
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Definition
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Term
| Values of PCO2 below 35 mmHg indicate: |
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Definition
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Term
| ___ ___ is the most common cause of acid-base imbalance. This occurs when a person breathes ___ or when gas exchange is impaired by diseases like ___, ___ ___, or ___. |
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Definition
- Respiratory acidosis
- shallowly
- pneumonia
- cystic fibrosis
- emphysema |
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Term
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Definition
| respiratory acidosis, pH less than 7.35 |
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Term
| Hyperventilation causes ___ ___. |
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Definition
| respiratory alkalosis, pH greater than 7.45 |
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Term
| ___ ___ ___ ___ account for all pH imbalances except those caused by abnormal blood carbon dioxide levels. |
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Definition
| - Mebabolic acid-base imbalance |
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Term
| With metabolic acid-base imbalance, ___ ___ levels fall above or below normal which is ___. |
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Definition
- bicarbonate ion
- 22-26 mEq/L |
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Term
| ___ ___ is the second most common cause of acid base imbalance. |
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Definition
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Term
| Typical causes of metabolic acidosis: |
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Definition
- too much alcohol consumption and excessive bicarbonate loss
- accumulation of lactic acid
- shock
- ketosis in diabetic crisis
- starvation
- kidney failure |
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Term
| Less than 22mEq/L of bicarbonate would be ___ ___. |
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Definition
metabolic acidosis
(b/c not enough base) |
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Term
| More than 24 mEq/L of bicarbonate ion would be ___ ___. |
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Definition
- metabolic alkalosis
(b/c too much base) |
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Term
| Rising blood __ and __ ___ indicate ___ ___. |
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Definition
- rising blood pH and bicarbonate
- metabolic alkalosis |
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Term
| Typical causes of metabolic alkalosis: |
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Definition
- vomiting of the acid of stomach
- intake of excessive base from antacids
- constipation, in which excessive bicarbonate is reabsorbed |
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Term
| The cause cannot correct itself. So metabolic acid-base imbalances will be corrected by the ___ ___, while respiratory acid base imbalance will be corrected by the ___. |
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Definition
- respiratory system
- kidneys |
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Term
| plasma pH is determined by what ratio? |
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Definition
CO2/HCO3-
(lungs determine CO2)
(kidneys determine HCO3-)
don't forget this:
CO2 + H2O > (carbonic anhydrase)> H2CO3 > HCO3- + H+ |
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Term
| In metabolic acidosis, blood pH is below ___ and bicarbonate levels are ___. The ___ system compensates by ___ rate and depth of breathing to ___ CO2 levels, eventually ___ falls below normal. Ultimately normal pH and ratio of ____ is reached again. |
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Definition
- 7.35
- low
- respiratory
- increasing
- decrease
- PCO2
- 1:24 |
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Term
| decrease in pH with metabolic acidosis activates the ____ in the ___ bodies. |
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Definition
- chemoreflex
- carotid bodies (sense excess hydrogen) |
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Term
| With metabolic alkalosis pH is over ___ and there are ___ bicarbonate levels. The ___ ___ compensates by causing ___ ___ breathing, which allows ___ __ to accumulate in the blood. |
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Definition
- 7.45
- elevated
- respiratory system
- slow, shallow
- carbon dioxide |
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Term
| With respiratory alkalosis you have too much bicarbonate and too little hydrogen in the blood, so the ___ reflex will be ___ causing you to breathe more slowly and shallow to allow CO2 to increase in plasma. |
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Definition
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Term
| with metabolic alkalosis, the respiratory compensation causes ___ PCO2. |
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Definition
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Term
| with metabolic acidosis, the respiratory compensation causes ____ PCO2. |
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Definition
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Term
| With respiratory acidosis the pH is less than 7.35 and there are high ___ and ___ levels. The high ___ is the cause of acidosis. The high ___ level indicates the kidneys are retaining ___ to offset the acidosis. |
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Definition
- PCO2 and bicarbonate
- PCO2
- bicarbonate
- bicarbonate |
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Term
| With respiratory alkalosis, there is a __ __ and __ ___. To compensate, the kidneys ___ bicarbonate by ___ or by failing to __ it. |
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Definition
- high pH
- low PCO2
- eliminate
- active secretion
- reclaim |
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Term
| with respiratory alkalosis the pH is : |
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Definition
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