1
Q
Acid
A
Proton donor
2
Q
Acidosis
A
Condition which causes an increase in [H+]
3
Q
Acidemia
A
Presence of greater than normal [H+] in blood
4
Q
Base
A
Proton acceptor
5
Q
Alkalosis
A
Condition which causes a decrease in [H+]
6
Q
Alkalemia
A
Presence of less than normal [H+] in blood
7
Q
CO2 added to H2O is an ________
A
Acid
8
Q
Explain the Law of Electrical Neutrality in regards to [HCO3-] and [H+]
A
Increase in [H+] = Increase in [HCO3-]
9
Q
Capacity
A
Volume added to a volume
10
Q
Acidic animal’s physical response to increased acidity of plasma
A
Release CO2 by panting
11
Q
An increase of acid or base is more common
A
Acid
12
Q
Organ that gets rid of the most acid
A
Lungs
13
Q
Importance of maintaining acid-base balance
A
Protein structure is dependent on prevailing [H+]
14
Q
Departure from normal [H+] has what influence on drugs?
A
Changes in the structures they bind to, but also because many drugs are acids or bases their ability to donate/accept H+ is altered
15
Q
Domestic animals can withstand proton concentrations that are between__________ the homeostatic normal [H+]
A
1/3 and 3 times
16
Q
At equilibrium, the concentrations of _____, ______ and _______ are constant
A
Water, Proton and Hydroxide
17
Q
Keq=
A
Keq= [H+] [OH-] / [H2O]
18
Q
[H2O] Constant = ______
A
55.6 M
19
Q
Keq constant = ______
A
1.8x10^-16
20
Q
pH =
A
-log10 [H+]
21
Q
Strong Acid/Base
A
One that readily dissociates
22
Q
Weak Acid/Base
A
One which does not readily dissociate
23
Q
Titratable Acidity/ Alkalinity
A
Total amount of proton/ proton acceptor which may be obtained from or complexed by another substance
24
Q
Dissociation constant, Ka
A
Relative strength of an acid or base
25
Ka = [H+] under what circumstances?
When protonated and dissociated species are present in equal concentrations
26
pK
pH at which protonated and dissociated species are present in equal concentrations
27
Buffer
Weak acid able to resist changes in pH in the face of addition or removal of H+ from a solution
28
Relationship between buffer and pK
Buffer does its best buffering at its pK because it exists abundantly in both the protonated and dissociated forms. Permitting it to donate or titrate H+
29
Henderson-Hasselbalch Equation
pH= pK + log10 [A-] / [HA]
30
\_\_\_\_\_\_\_\_\_\_\_\_\_\_ is the most important buffer in the body.
CO2 + H2O H2CO3 H+ + HCO3-
31
pH of plasma is \_\_\_\_\_.
7.4
32
In order for an animal to survive, its pH needs to be between\_\_\_\_\_\_\_\_\_\_.
6.9 and 8.0
33
Ratio of HCO3- : CO2 should be \_\_\_\_\_\_\_.
20:1
34
Most important phosphate buffer is \_\_\_\_\_\_\_.
HPO4 2-
35
Intracellular Buffers include:
1. H+ + HPO4 2- H2PO4- 2. H+ + Protein HProtein 3. H+ + HCO3- H2CO3
36
Interstitium Buffers include:
1. H+ + HCO3- H2CO3 2. H+ + HPO4 2- H2PO4- 3. H+ + Protein HProtein
37
CSF buffers include
1. H+ + HCO3- H2CO3
38
Tubular Filtrate Buffers include:
1. H+ + HCO3- H2CO3 2. H+ + HPO4 2- H2PO4- 3. H+ + NH3 NH4
39
Plasma Buffers include:
1. H+ + HCO3- H2CO3 2. H+ + Protein HProtein 3. H+ + HPO4 2- H2PO4-
40
Carbonic acid is found \_\_\_\_\_\_\_\_\_\_\_.
Carbonic acid is found **in all bodily fluids**.
41
Carbonic acid is found \_\_\_\_\_\_\_\_\_\_\_.
Carbonic acid is found **6.1**.
42
pH of most body fluids is between \_\_\_\_\_\_\_.
pH of most body fluids is between **7.0-7.4**.
43
pH of venous plasma is \_\_\_\_\_\_\_\_\_\_.
pH of venous plasma is **less than 7.4**.
44
pH of arterial plasma is \_\_\_\_\_\_\_\_\_\_\_.
pH of arterial plasma is **greater than 7.4**.
45
\_\_\_\_\_\_\_\_\_\_\_\_ cells and ___________ cells of the kidney are capable of raising plasma [HCO3-]
**Proximal tubule** cells and** alpha intercalated** cells of the kidney are capable of raising plasma [HCO3-]
46
The reaction which lowers H2CO3 is \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
The reaction which lowers H2CO3 is **H2CO3 \<--\> H2O + CO2**.
47
At equilibrium, there are aproximately 400 or more ________ molecules per H2CO3.
At equilibrium, there are aproximately 400 or more **CO2 **molecules per H2CO3.
48
CO2 in aqueous solution is an \_\_\_\_\_\_\_\_\_\_\_.
CO2 in aqueous solution is an **acid**.
49
Normal values of [HCO3-] is ___________ and P CO2 is ____________ in plasma.
Normal values of [HCO3-] is **24 mM** and P CO2 is **40 mmHg** in plasma.
50
Overall reactions which buffer plasma at pH 7.4 are \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Overall reactions which buffer plasma at pH 7.4 are
**H+ + HCO3- \<--\>H2CO3 \<--\> H2O + CO2**.
51
[HCO3-] / (0.03) P CO2 should equal _______ in plasma.
[HCO3-] / (0.03) P CO2 should equal **20** in plasma.
52
If [HCO3-] / (0.03) P CO2 is greater than 20, an ___________ is present resulting in \_\_\_\_\_\_\_\_\_\_\_\_\_.
If [HCO3-] / (0.03) P CO2 is greater than 20, an **alkalosis** is present resulting in **alkalemia**.
53
If [HCO3-] / (0.03) P CO2 is less than 20, an ___________ is present resulting in \_\_\_\_\_\_\_\_\_\_\_\_\_.
If [HCO3-] / (0.03) P CO2 is less than 20, an **acidosis** is present resulting in **acidemia**.
54
If [HCO3-] / (0.03) P CO2 is greater than 20 and there is no change in P CO2, a \_\_\_\_\_\_\_\_\_\_\_ is present.
If [HCO3-] / (0.03) P CO2 is greater than 20 and there is no change in P CO2, a **metabolic alkalosis** is present.
55
If [HCO3-] / (0.03) P CO2 is greater than 20 and there is no change in [HCO3-], a \_\_\_\_\_\_\_\_\_\_\_ is present.
If [HCO3-] / (0.03) P CO2 is greater than 20 and there is no change in [HCO3-], a **respiratory alkalosis** is present.
56
If [HCO3-] / (0.03) P CO2 is less than 20 and there is no change in [HCO3-], a \_\_\_\_\_\_\_\_\_\_\_ is present.
If [HCO3-] / (0.03) P CO2 is less than 20 and there is no change in [HCO3-], a **respiratory acidosis** is present.
57
If [HCO3-] / (0.03) P CO2 is less than 20 and there is no change in P CO2, a \_\_\_\_\_\_\_\_\_\_\_ is present.
If [HCO3-] / (0.03) P CO2 is less than 20 and there is no change in P CO2, a **metabolic acidosis** is present.
58
H+ + HCO3- \<---\> H2CO3 \<---\> H2O + CO2 is the predominant buffer system because:
1. [HCO3-] is relatively high
2. CO2 can be exhaled for rapid corrections when pH does depart from normal
3. Dissociated HCO3- and protonated CO2 forms can be regulated independently
59
Total CO2 (T CO2) is \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. It equals \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Total CO2 (T CO2) is **the sum of all the forms in which CO2 is transported in plasma/serum**. It equals **[HCO3-] + CO2 (dissolved) + [H2CO3]**.
60
Total CO2 (mM) = \_\_\_\_\_\_\_\_\_\_\_\_\_.
Total CO2 (mM) = **[HCO3-] (mM) + 0.03 PCO2 (mmHg)**.
61
Total CO2 (mM) = __________ mM
Total CO2 (mM) = **25.2** mM
62
\_\_\_\_\_\_\_\_\_\_ and __________ are the organs which are responsible for the ultimate removal of excess acid and/ or base.
**Kidneys** and **lungs** are the organs which are responsible for the ultimate removal of excess acid and/ or base.
63
When acid/base is added or removed at rates that exceed the rate of removal/addition by the lungs and kidney, as in disease states, an animal must \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
When acid/base is added or removed at rates that exceed the rate of removal/addition by the lungs and kidney, as in disease states, an animal must **rely on other organs to immediately/temporarily buffer the excess/deficiency**.
64
Alterations in plasma pH may reflect changes in the abilities of the _____________ and ____________ systems to respond to altered production/ loss of H+ by cells.
Alterations in plasma pH may reflect changes in the abilities of the **respiratory** and **renal** systems to respond to altered production/ loss of H+ by cells.
65
Acid production originates in _________ are a result of \_\_\_\_\_\_\_\_\_\_\_.
Acid production originates in **cells** are a result of **cellular metabolism**.
66
Buffers \_\_\_\_\_\_\_\_\_\_\_\_agains the products of \_\_\_\_\_\_\_\_\_.
Buffers **protect the cell **against the products of **its own metabolism**.
67
A cell must be able to increase/ decrease the export of ____________ as intracellular pH changes.
A cell must be able to increase/ decrease the export of **H+ and or/base** as intracellular pH changes.
68
A well known acid extruder is the \_\_\_\_\_\_\_\_\_\_\_.
A well known acid extruder is the **Na+-H+ antiport**.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Utilizes inwardly-directed Na+ concentration gradient to export H+
69
Best known acid loader is \_\_\_\_\_\_\_\_\_\_\_\_\_.
Best known acid loader is **HCO3- -Cl- Exchanger**.
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Utilizes the inwardly-directed Cl- concentration gradient to export HCO3-
70
Decreased intracellular pH results in increased activity of __________ and decreased activity of the \_\_\_\_\_\_\_\_\_\_\_\_\_.
Intracellular pH results in increased activity of **acid extruders**, and decreased activity of the **acid loaders.**
71
Decreased extracellular pH results in decreased activity of the ____________________ and increased activity of the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Decreased extracellular pH results in decreased activity of the **acid extruders** and increased activity of the **acid loaders**.
72
Decreae in extrcellular pH cause by one group of cells will result in increased _______ retention and increased __________________ of H+ in other groups of cells.
Decreae in extrcellular pH cause by one group of cells will result in increased **H+** retention and increased **intracellular buffering** of H+ in other groups of cells.
73
Behavior of extruders in some cells is dependent on \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_, _____________ and \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_..
Behavior of extruders in cells is dependent on **interstitial, intracellular** and **luminal pH**.
74
\_\_\_\_\_\_\_\_\_\_\_\_ and ___________ are frequently used in the clinical assessment of overall acid-base status.
**Anion Gap** and **Base Excess** are frequently used in the clinical assessment of overall acid-base status.
75
Number of negative charges \_\_\_\_\_\_\_\_\_\_the number of positive charges in all solutions.
Number of negative charges **equals **the number of positive charges in all solutions.
76
Clinical measurement usually includes only the major cations and major anions, in plasma these are \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Clinical measurement usually includes only the major cations and major anions, in plasma these are **Na+, K+, Cl- and HCO3-**.
77
Anion Gap
The difference between total anions and total cations in plasma
78
Anion Gap = \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Anion Gap = **Counted Cations - Counted Anions**
or
= Uncounted Cations - Uncounted Anions.
79
Base Deficit
The amount of acid (base) that would restore 1L of blood to normal acid/base composition.
80
Base Excess (deficit) is an indicator of overall \_\_\_\_\_\_\_\_\_\_\_\_\_.
Base Excess (deficit) is an indicator of overall **non-respiratory acid/base status**.
81
Base excess (deficit) is calculated from ___ and _____ usuing teh Siggaard-Anderson Nomogram.
Base excess (deficit) is calculated from **P CO2** and **pH** usuing teh Siggaard-Anderson Nomogram.
82
Base excess refers to blood rather than plasma and therefore includes the buffering ability of __________ in addition to the plasma HCO3-, protein and phosphate buffers.
Base excess refers to blood rather than plasma and therefore includes the buffering ability of **hemoglobin** in addition to the plasma HCO3-, protein and phosphate buffers.
83
Contribution of hemoglobin buffer depends on both the __________ of and ______ of hemoglobin.
Contribution of hemoglobin buffer depends on both the **concentration** and **pK** of hemoglobin.
84
Causes of metabolic acidiosis are related to conditions in which __________ is either added in excess or excreted poorly or ______ is lost excessively or reabsorbed poorly.
Causes of metabolic acidiosis are related to conditions in which **H+** is either added in excess or excreted poorly or **HCO3-** is lost excessively or reabsorbed poorly.
85
Titration acidosis
H+ is either added in excess or excreted poorly
86
Bicarbonate-Losing Acidosis
HCO3- is lost excessively or reabsorbed poorly
87
Common causes of metabolic acidosis:
1. Renal Insufficiency
2. Ketosis
3. Hyperkalemia
4. Pancreatic/Biliary Tract Obstruction
5. Diarrhea
6. Anaerobiosis/Ischemic Hypoxia
7. Ingestion of Ethylene Glycol
88
An increase in H+ during metabolic acidosis in plasma can be compensated for by \_\_\_\_\_\_\_\_\_\_\_\_.
An increase in H+ during metabolic acidosis in plasma can be compensated for by **increasing the loss of CO2**.
89
Respiratory compensation, while lowering ______ also lowers \_\_\_\_\_\_\_.
Respiratory compensation, while lowering **[H+]** also lowers **[HCO3-]**.
90
Extracellular buffering and intracellular buffering accompany respiratory compensation by:
1. H+A- entering the cell
2. H+A- catabolized by aerobic cells, resulting in CO2
3. H+ "enters" the cell in exchange for K+
91
Explain how H+ "enters" the cell in exchange for K+
Less H+ is pumped out of teh cell and presumably less ECF Na+ enters the cell, which decreases the amount of Na+ that can be pumped out of the cell by Na+-K+ ATPase. Less than the normal amount of K+ is pumped into the cell thereby promoting increased plasma [K+].
92
Metabolic Acidosis can promote \_\_\_\_\_\_\_\_\_\_.
Metabolic Acidosis can promote **hyperkalemia**.
93
Renal compensation for metabolic acidosis is to increase reabsorption of ______ at the \_\_\_\_\_\_.
Renal compensation for metabolic acidosis takes the form of increaed reabsorption of **HCO3-** at the **PCT**.
94
Synthesis of HCO3- is accomplished through increased production of _______ obtained through the metabolism of \_\_\_\_\_\_\_\_\_\_\_\_.
Synthesis of HCO3- is accomplished through increased production of **CO2** obtained through the metabolism of **glutamine**.
95
Glutamine is converted to ___________ and NH3 by \_\_\_\_\_\_\_\_\_\_\_\_\_.
Glutamine is converted to **glutamate** and NH3 by **glutaminase**.
96
Glutamate is converted to ____________ and NH3 which is either oxidized or converted to glucose, releasing a CO2 which is acted on by ____________ to produce __________ and H+.
Glutamate is converted to **alpha ketoglutarate** and NH3 which is either oxidized or converted to glucose, releasing a CO2 which is acted on by **carbonic anhydrase** to produce **HCO3-** and H+.
97
Unbound secreted H+ by the PCT has the tendancy to \_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Unbound secreted H+ by the PCT has the tendancy to **diffuse back thorugh tight junctions**.
98
Secreted H+ associates with secreted _______ to form _______ which does not allow passage through tight junctions.
Secreted H+ associates with secreted **NH3** to form **NH4+** which does not allow passage through tight junctions.
99
Activity of the ______________ cells of teh DCT/CCD/MCD is critical to normal acid-base balance.
Activity of the **alpha intercalated** cells of teh DCT/CCD/MCD is critical to normal acid-base balance.
100
Glutaminase activity is _____ dependent, increased ________ in the PCT leads to increased activity.
Glutaminase activity is **pH** dependent, increased **acidity** in the PCT leads to increased activity.
101
Urea and Glutamate are synthesized by the \_\_\_\_\_\_\_\_\_\_.
Urea and Glutamate are synthesized by the **liver**.
102
Metabolic acidosis is characterized by ________ plasma [H+], ________ [HCO3-] and ______ PCO2.
Metabolic acidosis is characterized by **increased** plasma [H+], **decreased **[HCO3-] and **decreased** PCO2.
103
All causes of __________ are related to compromised respiratory function, resulting in hypoventilation and increased P CO2.
All causes of **respiratory acidosis** are related to compromised respiratory function, resulting in hypoventilation and increased P CO2.
104
Common causes of respiratory acidosis:
1. Pneumonitis/Pneumonia
2. Pulmonary Edema
3. Bronchoconstriction
4. CNS Depression
5. Pneumothorax, Hydrothorax, Hemothorax, Chylothorax
6. Neurologic and Neuromuscluar Disorders
105
Increased levels of ______ will result in the production of more H+ and HCO3- levels will increase as well.
Increased levels of **CO2** will result in the production of more H+ and HCO3- levels will increase as well.
106
Renal compensation of respiratory acidosis takes the form of increased H+ __________ and increased HCO3- __________ and synthesis secondary to increased generation and uptake of CO2.
Renal compensation of respiratory acidosis takes the form of increased H+ **secretion** and increased HCO3- **reabsorption** and synthesis secondary to increased generation and uptake of CO2.
107
CO2 can cross all cell membranes, ___________ will experience an increase in intracellular H+ and HCO3-, including CNS chemoreceptors in respiratory acidosis.
CO2 can cross all cell membranes, **all cells in the body** will experience an increase in intracellular H+ and HCO3-, including CNS chemoreceptors in respiratory acidosis.
108
Acid extruders are inhibted by _________ in respiratory acidosis.
Acid extruders are inhibted by **decreased pH** in respiratory acidosis.
109
In respiratory acidosis, increased uptake of CO2 by _________ enables these cells to release more HCO3- in exchange for CL-
In respiratory acidosis, increased uptake of CO2 by **Red Blood Cells** enables these cells to release more HCO3- in exchange for CL-
110
Respiratory acidosis is characterized by _______ plasma [H+], \_\_\_\_\_\_\_\_\_\_ [HCO3-] and _______ P CO2.
Respiratory acidosis is characterized by **increased** plasma [H+], **increased** [HCO3-] and **increased** P CO2.
111
Metabolic alkalosis is related to conditions in which H+ is _______ excessively or HCO3- is _______ excessively to plasma.
Metabolic alkalosis is related to conditions in which H+ is **lost** excessively or HCO3- is **added** excessively to plasma.
112
Common causes of Metabolic Alkalosis:
1. Vomiting
2. Abomasal volvulus
3. Gastric Dilitation and Volvulus
4. Hyperadrenocorticism
5. Iatrogenic
113
Renal compensation for metabolic alkalosis takes the form of decreased HCO3- \_\_\_\_\_\_\_\_\_\_, largely as a result of decreased ________ of H+ accompanied by decreased ___________ of NH3/NH4+.
Renal compensation for metabolic alkalosis takes the form of decreased HCO3- **reabsorption**, largely as a result of decreased **secretion** of H+ accompanied by decreased **secretion** of NH3/NH4+.
114
Decreased HCO3- reabsorption results in increased ______________ in teh first half of the PCT in Metabolic Alkalosis.
Decreased HCO3- reabsorption results in increased **Cl- reabsorption** in teh first half of the PCT in Metabolic Alkalosis.
115
Alkalosis increases luminal membrane K+ conductance and Na+-K+ ATPase activity which results in \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Alkalosis increases luminal membrane K+ conductance and Na+-K+ ATPase activity which results in **K+ entering filtrate easily decreasing H+ entry into filtrate**.
116
\_\_\_\_\_\_\_\_\_\_\_ may develop as a result of the altered activities of principal cells and skeletal muscle cells in response to alkalosis.
**Hypokalemia** may develop as a result of the altered activities of principal cells and skeletal muscle cells in response to alkalosis.
117
Renal compensation for metabolic alkalosis accompanied by dehydration is not as efficient as one might expect due to __________ and \_\_\_\_\_\_\_\_\_\_.
Renal compensation for metabolic alkalosis accompanied by dehydration is not as efficient as one might expect due to **Angiotension II** and **Aldosterone**.
118
Angiotension II in response to dehydration promotes ___________ activity of basolateral Na+-K+ ATPase and of the luminal Na+-H+ antiport and basolateral Na+-HCO3- symport in PCT, thus _________ HCO3- reabsorption.
Angiotension II in response to dehydration promotes **increases** activity of basolateral Na+-K+ ATPase and of the luminal Na+-H+ antiport and basolateral Na+-HCO3- symport in PCT, thus** stimulating** HCO3- reabsorption.
119
Aldosterone stimulated by dehydration stimulates __________ H+ secretion and therefore ________ HCO3- reabsorption in principal cells of the DCT/CCD/MCD.
Aldosterone stimulated by dehydration stimulates **Increased** H+ secretion and therefore **increased** HCO3- reabsorption in principal cells of the DCT/CCD/MCD.
120
Abomasal voluvulus and GDV are examples of \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
Abomasal voluvulus and GDV are examples of **mixed acid-base disorders**.
121
Explain how GDV and Abomasal Voluvulus are mixed acid-base disorders.
Volume of fluid that collects in the lumen of the abomasum **may result in dehydration** that can cause **increased lactic acid production** by poorly perfused organs. Dilation may be so pronounced that it causes **compression of the caudal vena cava** increasing perfusion problems as well as **compressing the diaphragm** resulting in respiratory acidosis.
122
Metabolic Alkalosis is characterized by _______ plasma [H+], \_\_\_\_\_\_\_\_\_\_\_ [HCO3-] and ___________ PCO2.
Metabolic Alkalosis is characterized by **decreased** plasma [H+], **increased ** [HCO3-] and **increased** PCO2.
123
Causes of respiratory alkalosis related to \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_, resulting in hyperventilation and decreased \_\_\_\_\_\_\_\_.
Causes of respiratory alkalosis related to **increased respiratory function**, resulting in hyperventilation and decreased **P CO2**.
124
Common causes of respiratory alkalosis include:
1. CNS lesions
2. CNS inflammation
3. Pain
4. Severe hypoxemia
125
Renal compensation of respiratory alkalosis takes the for of decreased H+ __________ and decreased HCO3- \_\_\_\_\_\_\_\_\_.
Renal compensation of respiratory alkalosis takes the for of decreased H+ **secretion** and decreased HCO3- **reabsorption**.
126
Decreased HCO3- __________ is accompanied by increased Cl- \_\_\_\_\_\_\_\_\_\_\_\_.
Decreased HCO3- **reabsorption** is accompanied by increased Cl- **reabsorption**.
127
Hyperventilation can ________ body fluids so rapidly that consciousness could be lost before renal compensation has noticible effect.
Hyperventilation can **alkalinize** body fluids so rapidly that consciousness could be lost before renal compensation has noticible effect.
128
In hypoxemia, cellular producion of lactic acid that has what effect on alkalosis?
Decreases to some extent the alkalosis
129
Respiratory alkalosis is characterized by ______ plasma [H+], _____ [HCO3-] and ________ P CO2.
Respiratory alkalosis is characterized by **decreased** plasma [H+], **decreased** [HCO3-] and **decreased** P CO2.
130
Independent variables which altered, result in plasma changes of [Na+] and [HCO3-] are plasma \_\_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_\_, \_\_\_\_\_\_\_\_\_\_\_, and \_\_\_\_\_\_\_\_\_\_\_.
Independent variables which altered, result in plasma changes of [Na+] and [HCO3-] are plasma **[Na+]**, **[Cl-]**, **[lactate-]**, **[acetoacetate-]**, **[beta-hydroxybuterate-]**, [**protein-]**, and **[phosphate]**.
131
Strong cations in plasma include \_\_\_\_, \_\_\_\_, ____ and \_\_\_\_\_.
Strong cations in plasma include **Na+**, **K+**, **Ca++ **and **Mg++**.
132
Strong anions in plasma include \_\_\_\_, \_\_\_\_\_, \_\_\_\_\_\_, ______ and \_\_\_\_\_\_.
Strong anions in plasma include **Cl-**, **SO4 2-**, **lactate-**, **acetoacetate-** and **beta-hydroxybuterate-**.
133
In plasma the sum of the concentrations of ___________ is greater than the sume of the concentrations of \_\_\_\_\_\_\_\_\_\_.
In plasma the sum of the concentrations of **strong cations** is greater than the sume of the concentrations of **strong anions**.
134
Strong Ion Difference (SID)
Difference in the sum of strong anions and strong cations in plasma
135
If SID is positive, [H+] must be ______ then [OH-] thus plasma is \_\_\_\_\_\_\_\_\_.
If SID is positive, [H+] must be **less** then [OH-] thus plasma is **alkaline**.
