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AB1
Regulation of Hydrogen Ion Balance
22
Physiology
Professional
02/28/2013

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Cards

Term
what is the normal arterial plasma pH?
Definition
7.40 (range = 7.35-7.45)
Term
Why does the partial pressure of CO2 stay the same (around 40 mmHg) despite changes of acid/base concentrations in the blood?
Definition
The amount of bicarbonate is altered to fix acid base problems, not CO2
Term
Are CO2 and bicarbonate excretion dependent or independent of each other?
Definition
They are independent. COexcretion is under pulmonary control and bicarbonate secretion is under renal control
Term
What is the Law of Mass Action?
Definition

The Law of Mass Action is one example of Le Chatelier's principle, that the equilibrium in a chemical system responds to a change in concentration, temperature, or pressure by shifting in the direction which partially counteracts the imposed perturbation.

 

**For our purposes, it is how our body reacts to proton concentration changes in the arterial space

Term
Do mass action shifts work in open body systems?
Definition
No, only in closed body systems
Term
How does the kidney respond to acidosis?
Definition
reabsorbs bicarbonate and secretes protons (one for one)
Term
How much higher is the capacity of the lungs processing metabolic CO2 vs the ability of the kidneys to process HCO3 and H+?
Definition
The lungs are 150x more efficient at getting rid of high levels of CO2
Term
Where is most of the HCO3 reabsorbed in the nephron? why?
Definition
80% of bicarbonate is reabsorbed in the proximal tubule because carbonic anhydrase is found in the brush border
Term

Where is most of the H+ secreted in the nephron?

Definition
distal tubules and collecting duct
Term
What does carbonic anhydrase do?
Definition
Carbonic anhydrase accelerates the CO2 hydration reaction (forward rxn) and also accelerates the CO2 dehydration reaction going the other way. Which reaction it catalyzes depends on concentration of CO2 or bicarbonate (mass action shifts)
Term
where does NH3 (and NH4+) come from?
Definition

NH3 + glutamate ---> glutamine

NH3 is a metabolic product of glutamine

 

NH3 + H+ ---> NH4+

NH3 combines with H+ in the proximal to form NH4+ which accounts for almost all of the H+ secreted in proximal tubule (otherwise, there is little net secretion of H+ before distal nephron)

Term
What is the difference between Type A and Type B intercalated cells?
Definition

Type A cells secrete protons and transport bicarbonate into the interstitium

Type B cells secrete bicarbonate and transport protons into the interstitium

 

(These two types can switch back and forth because their transporters can be switched between apical and basolateral membranes)

Term
How much more acidic is the distal nephron than the arterial plasma?
Definition

1000x conc of protons in the distal nephron

 

plasma pH = 7.4

distal nephron/urine pH = 4.4

Term
What are the three forms of secreted protons in the urine?
Definition

(1) free protons which generate the urinary pH

(2) titratable acids (especially dihydrogen phosphate)

(3) ammonium ions (which are diffusion trapped)

Term
Where does ammoniagenesis occur?
Definition
proximal tubule
Term
Where is glutamine synthesized? What are the two main components?
Definition

in the liver

 

NH4+ + bicarbonate = glutamine

Term
Where does ammonium reabsorption occur? What protein transporter is responsible for the majority of reabsorption?
Definition

thick ascending limb

 

NKCC multiporter (ammonium is substituted for K+)

Term
Where is ammonium secreted back into urine? What protein transporter is used?
Definition

common collecting duct (inner medulla)

 

Na/K ATPase (ammonium substitutes for K+)

Term
What are the pKas of sulfuric acid, dihydrogen monophosphate and ammonia?
Definition

sulfuric acid pKa = 1.9

dihydrogen monophosphate pKa = 6.8

ammonia pKa = 9.3

Term
Which acid is always in its dissociated form (basic form) in urine?
Definition
sulfuric acid
Term
Which acid is titratable in the urinary pH range (4.4 to 7.4) ?
Definition
dihydrogen monophosphate
Term
Which acid is always in its undissociated form (acid form) in urine?
Definition
ammonium
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