Acid-Base Balance (M)
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What are the 2 principle of rxns (/ types) of anion gap?
1) Na^+ - (Cl^- + HCO3^-) 2) (Na^+ + K^+) - (Cl^- + HCO3^-)
What is the expected anion gap of Na^+ - (Cl^- + HCO3^-)?
7 - 16 mmol/L
What is the expected anion gap of (Na^+ + K^+) - (Cl^- + HCO3^-)?
10 - 20 mmol/L
What are the causes of increased anion gap?
1) Uremia 2) Lactic acidosis 3) Ketoacidosis 4) Hypernatremia 5) Ingestion of methanol 6) Ethylene glycol 7) Salicylate
What is the other fxn of increased anion gap?
It is also used as an assessment of instrument errors
What are the causes of decreased anion gap?
1) Hypoalbuminemia 2) Hypercalcemia
What is a buffer?
It is a system that can resist change in pH
What is the characteristic of buffer?
It is composed of a weak acid or a weak base and its corresponding salt
What are the 4 buffer systems of clinical importance w/c exist in whole blood?
1) The bicarbonate-carbonic acid buffer system 2) The protein buffer system 3) The phosphate buffer system 4) The hemoglobin buffer system
What does the bicarbonate-carbonic acid buffer system use?
1) HCO1^- 2) H2CO3
What is the fxn of HCO1^- and H2CO3 (in bicarbonate-carbonic acid buffer system)?
To minimize pH changes in plasma and erythrocytes
What is the most impt buffer system in plasma?
The bicarbonate-carbonic acid buffer system
What does the protein buffer system use?
Plasma proteins
What is the fxn of plasma proteins (in the protein buffer system)?
To minimize pH changes in the blood
What are used by the phosphate buffer system?
1) HPO4^-2 2) H2PO4^-1
What is the fxn of HPO4^-2 and H2PO4^-1?
To minimize pH changes in plasma and erythrocytes
What does the hemoglobin buffer system use?
Hemoglobin
Where is the hgb (in the hemoglobin buffer system) present?
In RBCs
What is the fxn of hgb (in the hemoglobin buffer system)?
To minimize pH changes in the blood
What is the most impt intracellular buffer?
The hemoglobin buffer system
What is respiration?
It is the process to supply cells w/ O2 for metabolic processes and remove the CO2 produced during metabolism
What is partial pressure?
In a mixture of gases, it is the amt of pressure contributed by each gas to the total pressure exerted by the mixture
When does acidemia occur?
When arterial blood pH is < 7.35
When does alkalemia occur?
When arterial blood pH is 7.45 >