Acid-Base

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Clinical Chemistry
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1

acid

any substance that can yield a hydrogen ion (H+) or hydronium ion when dissolved in water; releases H+ proton

2

base

substance that can yield a hydroxyl ion (OH-); accepts H+ proton

3

6.1

disassociation constant

4

pKa disassociation constant

formed into conjugate acid or conjugate base and a hydroxide ion; negative log of ionization constant of an acid

5

pK<3

strong acid

6

pK>9

strong base

7

pH

negative log of the hydrogen ion concentration

8

pH calculation

pK + log ([base]/[acid]); represents the hydrogen concentration

9

buffer

combination of a weak acid and/or a weak base and its salt; resists changes in pH; effectiveness depends on its pK and pH of environment

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7.35-7.45

pH of blood reference range; deviations cause alterations of chemical reaction rate and metabolic processes

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acid base balance

maintains pH homeostasis and maintenance of H+ concentration

12

decreases pH (acidosis)

increased H+ concentration

13

increases pH (alkalosis)

decreased H+ concentration

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acidosis

ph <7.35; altered consciousness, coma, and death

15

alkalosis

pH >7.45; neuromuscular irritability, tetany, loss of consciousness, and death

16

respiratory and renal

the two systems that regulate pH

17

weak acids

good buffers since they can tilt a reaction in the other direction

18

strong acids

poor buffers because they make the system more acidic

19

bicarbonate/carbonic acid

the most important buffer system in the body; accounts for majority of buffering capacity in extracellular space

20

hemoglobin and proteins

two important buffer systems in the body

21

phosphates

least important buffer system in the body

22

hemoglobin buffer system

binds CO2, binds and transports hydrogen and oxygen, participates in chloride shift, and maintains blood pH as hemoglobin changes from oxyhemoglobin to deoxyhemoglobin

23

hemoglobin equation

HHbO2 + KHCO3 -> H2CO3 + KHbO2

24

protein buffers

primarily cellular buffers; some acids, some bases; ionizable side chains to pick up or release H+ and CO2; account for about 14% of blood buffering capacity

25

phosphate buffer system

has a major role in elimination of H+ via kidney; assists in the exchange of sodium for hydrogen; essential within the erythrocytes

26

phosphate buffer system equation

(HPO^-2)4 + H+ <-> (H2PO-)4

27

bicarb buffer system equation

H+ + HCO3 ^- (bicarbonate) (excreted in urine) <-> H2CO3 (carbonic acid) <-> H2O + CO2 (excreted by lungs)

28

lactate

by-product of an emergency mechanism that produces a small amount of ATP when oxygen is severely diminished; not regulated, levels rise rapidly when oxygen delivery decreases below a critical level

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0.5-2.2 mEq/L

lactate reference range

30

Henderson-Hasselbalch Equation

pH = pK' + log (cHCO33-/[a X PCO2])

a=cd (acid)

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20:1

the normal ratio of HCO3- to H2CO3

32

kidneys

metabolic condition alternating bicarbonate

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increased bicarbonate

kidneys compensate by a decrease in the amount of reabsorption and allow the bicarbonate to be eliminated in the urine

34

decrease bicarbonate

kidneys compensate by increasing the amount of reabsorption and put more bicarbonate back into the circulation

35

lungs

organ affecting dissolved CO2 alterations; retains or eliminates dissolved CO2

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increased CO2

lungs react by blowing off more CO2 by hyperventilating

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decreased CO2

lungs hypoventilate to retain CO2

38

respiratory

first system to compensate to maintain pH